Atrial fibrillation in primary aldosteronism.
BACKGROUND
Primary aldosteronism (PA) is caused by autonomous hypersecretion of aldosterone from the adrenal cortex, classically from an adenoma, resulting in sodium and water retention, hypokalaemia and raised blood pressure. The sodium and water retention causes suppression of renin release. The possible cardiac sequelae of aldosterone excess are encountered primarily in patients with secondary hyperaldosteronism due to heart failure, where plasma renin, angiotensin and aldosterone levels are all raised. However, there is also evidence that primary aldosterone excess, in the presence of low renin levels, may also be cardiotoxic.


METHODS
In this report, we describe five patients with PA, who developed atrial fibrillation (AF) in the absence of structural cardiac lesions and in one case despite good control of blood pressure and electrolytes.


CONCLUSIONS
In patients with hypertension and AF, who have no evidence of coronary disease or any other underlying cause of AF with preserved systolic function, a diagnosis of PA should be considered.
Watson
Timothy
T
Department of Medicine, City Hospital, Birmingham B18 7QH, England, UK.
Karthikeyan
Vellore J
VJ
Lip
Gregory Y H
GY
Beevers
D Gareth
DG
D000328:Adult; D000450:Aldosterone / Q000097:blood; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000175:diagnosis; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology; D007008:Hypokalemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood
D000450:Aldosterone; D012083:Renin