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Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
08:45

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients

Published on: April 18, 2025

Contrast stress echocardiography in hypertensive heart disease

Mai Tone Lønnebakken1, Ashild E Rieck, Eva Gerdts

  • 1Department of Heart Disease, Haukeland University Hospital, Bergen, Norway. mai.tone.lonnebakken@helse-bergen.no

Cardiovascular Ultrasound
|November 19, 2011
PubMed

Insights

Hypertension can cause myocardial ischemia without coronary artery disease via left ventricular hypertrophy and arterial stiffness. Contrast stress echocardiography diagnosed this in a patient with resistant hypertension and angina.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Imaging

Background:

  • Hypertension is linked to atherosclerosis and cardiovascular changes.
  • Myocardial ischemia in hypertension can occur independently of coronary artery disease.
  • Pathophysiological mechanisms include left ventricular hypertrophy, arterial stiffness, and endothelial dysfunction.

Observation:

  • A case report details a hypertensive patient experiencing angina pectoris.
  • The patient had no significant obstructive coronary artery disease.
  • Diagnostic challenge: differentiating ischemia causes in hypertensive patients.

Findings:

  • Contrast stress echocardiography identified myocardial ischemia.
  • Ischemia was attributed to severe resistant hypertension.
  • Complications included concentric left ventricular hypertrophy and increased arterial stiffness.

Implications:

  • Highlights the utility of contrast stress echocardiography in diagnosing non-obstructive ischemic heart disease in hypertensive patients.
  • Emphasizes the cardiac impact of resistant hypertension, including structural and functional changes.
  • Suggests a need for comprehensive cardiovascular assessment in hypertensive individuals presenting with angina.

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