RESUMEN
The retina is an organ frequently affected by ischemic changes. Retinal arterial occlusion can be considered the equivalent of stroke, in terms of presentation, management and treatment. In addition to a specific ophthalmological treatment systemic management is essential with an appropriate study and control of cardiovascular risk factors considering these patients of a very high cardiovascular risk. In this consensus document we aim to provide an update on this relatively frequent pathology in our practices, considering the importance of an early and systematic action.
RESUMEN
Multiple diagnostic entities are included among the causes of secondary arterial hypertension, so an appropriate screening is essential to diagnose potentially treatable pathologies. Genetic syndromes occupy a small percentage of these causes. The latter group includes Liddle syndrome, a rare genetic disease with autosomal dominant inheritance, caused by gain-of-function mutations in the genes that code for the epithelial sodium channel (ENaC), involved in sodium reabsorption in the distal renal tubules. The presence of a family history of arterial hypertension with onset at an early age and hypokalemia in some of them should lead to the suspicion of this genetic disorder, which must be confirmed with genetic tests. We describe a case, genetically confirmed, in which hypertension refractory to conventional treatment is the only manifestation of said syndrome, making diagnosis difficult and delayed until adulthood.
Asunto(s)
Hipertensión , Hipopotasemia , Síndrome de Liddle , Adulto , Canales Epiteliales de Sodio/genética , Humanos , Hipertensión/etiología , Hipopotasemia/etiología , Síndrome de Liddle/etiología , Síndrome de Liddle/genéticaRESUMEN
Leiomyomas are benign tumors derived from smooth muscle tissue that rarely present outside the uterus. These tumors do not usually show FDG uptake. We present the case of a patient with hypertension refractory to treatment and a lesion arising from inferior vena cava, that shows intense FDG uptake in PET/CT scan, suggestive of paraganglioma, with a final histological diagnosis of leiomyoma.
Asunto(s)
Fluorodesoxiglucosa F18 , Leiomioma/diagnóstico por imagen , Paraganglioma/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radiofármacos , Neoplasias Vasculares/diagnóstico por imagen , Vena Cava Inferior/diagnóstico por imagen , 3-Yodobencilguanidina , Diagnóstico Diferencial , Fluorodesoxiglucosa F18/farmacocinética , Humanos , Hipertensión , Leiomioma/metabolismo , Masculino , Persona de Mediana Edad , Radiofármacos/farmacocinética , Neoplasias Vasculares/metabolismo , Vena Cava Inferior/metabolismoRESUMEN
The number of patients who suffer refractory arterial hypertension and chronic heart failure in advanced stages is currently increasing. The case is presented of a patient with an implantable cardioverter defibrillator, and with the dual indication of chronic heart failure and refractory arterial hypertension, who required the implanting of a baroreceptors activation therapy device of the carotid sinus. As far as it is known, it is the first case reported in Spain?