Heart failure: An unusual cause

Renal artery aneurysms are uncommon and are usually detected when renal angiography is performed for other indications. Less often, they may present with loin pain, hematuria, renovascular hypertension, and a palpable mass. Renal artery aneurysms larger than 1.0 cm presenting with resistant hypertension and all aneurysms larger than 2.0 cm are the usual indications for surgical intervention. The most important indications for surgical repair appear to be the presence of concurrent hypertension and female gender (because of the higher chances of catastrophic rupture of the aneurysm during pregnancy). Surgery may result in better control of hypertension in some cases. In this report, we highlight a rare case of a huge aneurysm of the left renal artery presenting with resistant renovascular hypertension and heart failure. Aneurysmectomy, followed by repair of the renal artery, resulted in good control of heart failure and hypertension.