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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
Management of Hypertensive Emergency in the Setting of Primary Aldosteronism Complicated by Heart Failure With
Tauseef Sarguroh1, Aliziya Punjwani2
1Internal Medicine/Nephrology, Franciscan Health, Olympia Fields, USA.
Abstract:
We present a case of a 49-year-old man with a past medical history of uncontrolled hypertension and alcohol use disorder presently in sustained remission who presented to the ED with shortness of breath. He was admitted for the management of hypertensive emergency and hypokalemia and was later found to have primary aldosteronism complicated by heart failure with reduced ejection fraction. The patient's treatment-resistant hypertension as well as hypokalemia, which was refractory to repletion, resolved with mineralocorticoid-receptor-antagonist pharmacotherapy. After a single oral dose of spironolactone 25 mg, the patient's mean arterial pressure decreased by approximately 26.5%. Spironolactone 25 mg was continued twice daily not only as the mainstay treatment for primary aldosteronism but also to optimize guideline-directed medical therapy for the treatment of heart failure with reduced ejection fraction.
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