1/19. Transdiaphragmatic graft replacement for coarctation suprarenal abdominal aorta.A 17-year-old boy was referred to us with severe hypertension, headache and intermittent lower extremity claudication. Approximately 3 months prior to admission, he began to experience headache and pain in the posterior aspect of the right thigh and calf upon walking only 20 m. Occasionally, similar symptoms developed in the left leg which were nearly always of the same intensity as on the right. Arterial blood pressure on admission to our hospital was 220/140 mmHg in the arm. After physical examination and diagnostic tests, he was operated on with the diagnosis of coarctation of the abdominal aorta. The purpose of this paper is to report on a patient having an area of coarctation just above the level of renal arteries who presented with severe hypertension and intermittent claudication and in whom there was complete relief of signs and symptoms after appropriate surgical intervention.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/19. hypertension in the young adult--come feel the pulse.hypertension occurring in teenagers and young adults is uncommon. Though the most common form is still essential hypertension, secondary causes are more commonly found here than in older adults. Renal, cardiovascular and endocrine diseases constitute most of these causes. Coarctation of the aorta is the most common cardiovascular cause of hypertension, and its importance lies in the fact that it is correctable, and that its persistence often leads to dangerous complications and early death. The cardinal sign of differential pulse and blood pressures between the upper and lower limbs can be detected clinically. Hence, the importance of a detailed physical examination in all young hypertensives, including palpation of all the pulses, cannot be overemphasized. We present 2 hypertensive young men who were found to have isolated coarctation of the aorta.The lesion in the first patient was located postductally just distal to the left subclavian artery.This area has been found to be the most common site of coarctation.The second patient had an unusual mid-thoracic coarctation. The clinical and radiological features as well as complications are highlighted. In young hypertensive patients, a high index of suspicion may enable the physician to make a timely diagnosis and hence avert the potentially disastrous complications that may arise in undetected cases.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
3/19. Spontaneous false aneurysm of left internal mammary artery.A 15-year-old female patient presented with a history of a mass just medial to the left breast and fever. Her physical examination revealed upper extremity hypertension, delayed and diminished pulsations in the femoral arteries and a midsystolic murmur over the back. On catheterization of the aorta a 45 mmHg systolic pressure gradient was obtained across the coarctation segment. The selective left internal mammary artery angiography showed the relationship of distal portion with false aneurysm. A magnetic resonance scan showed a left parasternal mass extending anteriorly.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
4/19. Secondary hypertension in a migrant farm worker: a case report of coarctation of the aorta.PURPOSE: To report a case of undetected aortic coarctation in an adult Hispanic migrant farm worker that presented with uncontrolled hypertension and transient left flank pain. A primary care overview of the disorder, clinical diagnosis, testing, and treatment are discussed. DATA SOURCES: Case report, scientific literature, diagnostic evidence. CONCLUSIONS: Coarctation of the aorta is a significant congenital cardiovascular anomaly and cause of secondary hypertension. The majority of patients with coarctation of the aorta are diagnosed during infancy. Older children and adults may have a subtle presentation, but can be identified as being at risk by having a thorough history and physical, as well as noninvasive diagnostic testing. IMPLICATIONS FOR PRACTICE: Primary care providers must have a high degree of suspicion in patients with risk factors or in individuals that may have not benefited from adequate health screening. early diagnosis and correction of the coarctation is important to reduce persistent postoperative hypertension and improve long-term survival.- - - - - - - - - - ranking = 0.069791498421777keywords = physical (Clic here for more details about this article) |
5/19. Coarctation of the descending thoracic aorta diagnosed during pregnancy.BACKGROUND:Coarctation of the aorta is an uncommon condition complicating pregnancy. It is often associated with hypertension and usually involves the aortic isthmus. CASE: Coarctation of the descending thoracic aorta was found at 21 weeks' gestation after physical findings of hypertension, a holosystolic murmur over the entire left hemithorax, and diminished lower extremity pulses. The diagnosis led to thoracotomy and placement of a graft bypass after an otherwise uneventful pregnancy. CONCLUSION: Unusual sites of coarctation of the aorta complicating pregnancy include the descending thoracic aorta.- - - - - - - - - - ranking = 0.069791498421777keywords = physical (Clic here for more details about this article) |
6/19. Abdominal coarctation in a hypertensive female collegiate basketball player.The purpose of the preparticipation examination is to identify health conditions that might adversely affect an athlete while participating in sport. hypertension is the most common. This case report details a female basketball player found to be hypertensive, and complaining of fatigue, at her preparticipation physical examination. Presentation, diagnostics, treatment, and final outcome of coarctation involving the abdominal aorta are summarised.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
7/19. Asymptomatic severe aortic coarctation in an 80-year-old man.survival to advanced age is exceptional in patients with unrepaired aortic coarctation. We report the case of a hypertensive 80-year-old man with coarctation of the aorta who was otherwise asymptomatic. Coarctation was suspected when a femoral-radial pulse delay was noted during his routine physical examination. A 25-mmHg systolic blood pressure gradient between the upper and lower extremities was detected. Subsequent magnetic resonance angiography, aortography, and coronary angiography revealed severe coarctation of the aorta, well-developed collateral vessels, and severe coronary artery disease that included the left main artery. coronary artery bypass grafting was performed, and the coarctation was managed conservatively with antihypertensive medication. At the 1-year follow-up visit, the patient was still asymptomatic and maintained a normal blood pressure with medication.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
8/19. aortic coarctation suspected by Doppler echocardiography of renal arteries in hypertensive patients referred to a hospital outpatient hypertension clinic.Coarctation of the aorta is the fourth most frequent form of congenital cardiovascular disease, which is diagnosed by the presence of higher blood pressures in the arms than in the legs. In this report we describe 3 cases of aortic coarctation, in which the correct diagnosis was suspected only months or years after the detection of hypertension, when a renal ultrasound examination was requested, despite the fact that the hallmarks of the disease were present at the physical examination in all patients. A marked reduction in renal flow velocities was suggestive of proximal aortic stenosis in all 3 cases. We conclude that the diagnosis of aortic coarctation, an uncommon but not so rare form of secondary hypertension, by renal ultrasonography rather than by a complete physical examination, reflects a commitment failure of physicians in everyday management of hypertension.- - - - - - - - - - ranking = 2keywords = physical examination, physical (Clic here for more details about this article) |
9/19. aorta coarctation presenting with intracranial aneurysm rupture.Most vascular diseases have a tendency to affect both heart and the brain. Intracranial aneurysms are more often found in patients with aorta coarctation than in general population, and aneurysm rupture occurs much earlier in these patients. Here, we report a case of aorta coarctation which was diagnosed with its cerebrovascular complications. Before presenting with cerebrovascular complications, the disease can easily be diagnosed with physical examination and non-invasive radiological investigations like echocardiography or cardiac magnetic resonance imaging.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
10/19. Echocardiographic diagnosis of secondary coarctation complicating the repair of a traumatic pseudoaneurysm of the aorta.An 18-year-old patient underwent repair of traumatic aortic pseudoaneurysm. Postoperatively, the physical examination showed hypertension with 30 mm Hg gradient between the upper and lower extremities. Doppler echocardiographic evaluation demonstrated a new (secondary) aortic coarctation at the site of the repair. Transesophageal echocardiography revealed the detailed anatomy and the cross-sectional area of the coarctation.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
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