title: Exertional dyspnea as a symptom of infrarenal aortic occlusive disease.
abstract: Advanced atherosclerosis of the aorta can cause severe ischemia in the kidneys, refractory hypertension, and claudication. However, no previous reports have clearly associated infrarenal aortic stenosis with shortness of breath. A 77-year-old woman with hypertension and hyperlipidemia presented with exertional dyspnea. Despite extensive testing and observation, no apparent cause for this patient's dyspnea was found. Images revealed severe infrarenal aortic stenosis. After the patient underwent stenting of the aortic occlusion, she had immediate symptomatic improvement and complete resolution of her dyspnea within one month. Twelve months after vascular intervention, the patient remained asymptomatic. In view of the distinct and lasting elimination of dyspnea after angioplasty and stenting of a nearly occluded infrarenal aortic lesion, we hypothesize that infrarenal aortic stenosis might be a treatable cause of exertional dyspnea. Clinicians should consider infrarenal aortic stenosis as a possible cause of dyspnea. Treatment of the stenosis might relieve symptoms.
authors: Departments of Medicine (Drs. Harkness, Porto Carreiro, Schott, Sozio, and Zakaria) and Vascular and Endovascular Surgery (Dr. Malas), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224.
authors: Stacey L
authors: SL
authors: Schott
authors: Departments of Medicine (Drs. Harkness, Porto Carreiro, Schott, Sozio, and Zakaria) and Vascular and Endovascular Surgery (Dr. Malas), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224.
authors: Fernanda Porto
authors: FP
authors: Carreiro
authors: Departments of Medicine (Drs. Harkness, Porto Carreiro, Schott, Sozio, and Zakaria) and Vascular and Endovascular Surgery (Dr. Malas), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224.
authors: James R
authors: JR
authors: Harkness
authors: Departments of Medicine (Drs. Harkness, Porto Carreiro, Schott, Sozio, and Zakaria) and Vascular and Endovascular Surgery (Dr. Malas), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224.
authors: Mahmoud B
authors: MB
authors: Malas
authors: Departments of Medicine (Drs. Harkness, Porto Carreiro, Schott, Sozio, and Zakaria) and Vascular and Endovascular Surgery (Dr. Malas), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224.
authors: Stephen M
authors: SM
authors: Sozio
authors: Departments of Medicine (Drs. Harkness, Porto Carreiro, Schott, Sozio, and Zakaria) and Vascular and Endovascular Surgery (Dr. Malas), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224.
authors: Sammy
authors: S
authors: Zakaria
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D001027:Aortography; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D003251:Constriction, Pathologic; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D005082:Physical Exertion; D011237:Predictive Value of Tests; D015607:Stents; D016896:Treatment Outcome
keywords: Aorta, abdominal/pathology; aortic diseases/diagnosis/therapy; arterial occlusive diseases/therapy; arteriosclerosis/complications/physiopathology; diagnosis, differential; dyspnea/complications; renal artery obstruction/complications/physiopathology; stents; treatment outcome