Paroxysmal hypertension in aortitis syndrome

Area of Science:

• Cardiology
• Vascular Medicine
• Nephrology

Background:

• Aortitis syndrome is an inflammatory condition affecting the aorta.
• Baroreceptor dysfunction can lead to significant blood pressure dysregulation.
• Hypertensive emergencies require prompt diagnosis and management.

Observation:

• Three patients with aortitis syndrome presented with paroxysmal hypertension.
• Stenotic carotid and subclavian arteries and active inflammation were noted.
• Hypertensive attacks reached >230 mm Hg systolic with heart rate >100 bpm.

Findings:

• Steroid hormone therapy successfully terminated hypertensive episodes.
• Two patients experienced attacks with anginal pain and ST depression, linked to baroreceptor disturbance.
• One patient had post-micturition hypertension, possibly due to baroreceptor overshooting.

Implications:

• Baroreceptor dysfunction is a key factor in aortitis-related hypertension.
• Effective management of aortitis syndrome can resolve associated hypertensive crises.
• Understanding baroreceptor involvement offers insights into managing vascular inflammation and blood pressure.