Measurement of leg blood pressure: the most straightforward way to the diagnosis.
until further notice
SourceNetherlands Journal of Medicine, 66, 2, (2008), pp. 81-84
Article / Letter to editor
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Netherlands Journal of Medicine
SubjectIGMD 1: Functional imaging; IGMD 5: Health aging / healthy living; NCEBP 14: Cardiovascular diseases; UMCN 1.1: Functional Imaging; UMCN 2.2: Vascular medicine and diabetes
Two adult patients with presumed primary hypertension are presented. In the first patient the diagnosis of coarctation of the aorta was straightforward while in the second patient there was a substantial delay in reaching the correct diagnosis. A 32-year-old patient was analysed for hypertension in the outpatient clinic. At physical examination a systolic cardiac murmur was present and leg blood pressure was not measurable. Magnetic resonance imaging angiography showed a severe coarctation of the thoracic aorta with extensive distended collateral blood vessels. A second patient was a 31-year-old man referred with longstanding hypertension and an unsatisfactory blood pressure response to treatment. Previously, a diagnosis of primary hypertension was made. Renal computed tomography angiography excluded renal artery stenosis as a cause of hypertension but disclosed many distended collateral blood vessels in the musculus rectus abdominis and in the upper abdominal area. Leg blood pressure was measured and further analysis revealed a coarctation of the aorta. Both patients illustrate and emphasise the importance of leg blood pressure measurement at a first analysis of adult hypertensive patients and should always be performed when hypertension is accompanied by murmurs or weak femoral pulsations.
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