Pathogenesis of paradoxical hypertension after coarctation resection.

Abstract:

:The pathogenesis of paradoxical hypertension after resection of coarctation of the aorta was investigated by comparing the course of seven children undergoing repair of coarctation with five acyanotic children undergoing elective cardiovascular surgery. During the first 24 hours after surgery, all coarctation patients demonstrated a rise in systolic blood pressure (35 +/- 15.5 mm Hg; P less than 0.001), a significant depression in cold pressor test response, and only a slight elevation in plasma renin activity. In the next 24-72 hours, coarctation patients developed a rise in diastolic blood pressure (26.8 +/- 10.6 mm Hg; P less than 0.001), plasma renin activity (22.9 +/- 10.2/ml/hr; P less than 0.001) and fluid retention. By contrast, control patients had no significant postoperative changes. Abdominal pain occurred in five coarctation patients during the period of maximal plasma renin activity. The data suggest that the sympathetic nervous system may be responsible for the initial phase of hypertension after coarctation resection and that the renin angiotension system plays a major role in the second phase of hypertension and in the pathogenesis of mesenteric arteritis.

journal_name

Circulation

journal_title

Circulation

authors

Rocchini AP,Rosenthal A,Barger AC,Castaneda AR,Nadas AS

doi

10.1161/01.cir.54.3.382

subject

Has Abstract

pub_date

1976-09-01 00:00:00

pages

382-7

issue

3

eissn

0009-7322

issn

1524-4539

journal_volume

54

pub_type

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