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Do we need more vascular imaging for the screening of secondary hypertension? Mid-aortic syndrome in a young male adult

Journal of Human Hypertension volume 34, pages 668–670 (2020)Cite this article

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Middle aortic or mid-aortic syndrome (MAS) is a rare variety of aortic coarctation, located in the distal thoracic aorta and/or proximal abdominal aorta, and it commonly involves renal and splanchnic branches. MAS is usually diagnosed in children, and the typical presentation is severe resistant hypertension with relative hypotension distal to the aortic stenosis, often associated with headache, early fatigue on exertion and bilateral lower-limb claudication. However, MAS can also be found in adults who may not present with typical signs and symptoms of the condition and it should be considered in the diagnostic workout for secondary causes of hypertension.

A 21-year-old White British man was referred to the Hypertension Unit, St. Thomas’ Hospital, London for the exclusion of secondary causes of hypertension. The subject was found to be hypertensive only a few months before, and he was not on medical treatment at the time of the evaluation. Comorbidities included increased body mass index (27.5 kg/m2) and anxious-depressive disorder (on treatment with Fluoxetine and Mirtazapine). Past medical history revealed that at the age of 13 he was incidentally found having a mild systolic murmur, but the cardiologic evaluation was unremarkable with normal blood pressure (BP) values (125/75 mmHg) and no cardiac hypertrophy. The patient’s family history was negative for hypertension and cardiovascular disease.

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Authors and Affiliations

  1. King’s College London, British Heart Foundation Centre, London, UK

    F. Morselli, P. J. Chowienczyk & L. Faconti

  2. King’s College London, School of Imaging Sciences and Biomedical Engineering, London, UK

    N. Karunanithy

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  1. F. Morselli
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Correspondence to L. Faconti.

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FM, NK, PJC and LF declare that they do not have conflict of interests.

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Morselli, F., Karunanithy, N., Chowienczyk, P.J. et al. Do we need more vascular imaging for the screening of secondary hypertension? Mid-aortic syndrome in a young male adult. J Hum Hypertens 34, 668–670 (2020). https://doi.org/10.1038/s41371-020-0305-9

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