Imaging or Adrenal Vein Sampling Approach in Primary Aldosteronism? A Patient-Based Approach.
Irene TizianelChiara SabbadinCaterina MianCarla ScaroniFilippo CeccatoPublished in: Tomography (Ann Arbor, Mich.) (2022)
Primary aldosteronism (PA) is the most frequent cause of secondary hypertension, associated with an increased risk of cardiovascular and cerebral disease, compared to essential hypertension. Therefore, it is mandatory to promptly recognize the disease and offer to the patient the correct diagnostic-therapeutic process in order to reduce new-onset cardiovascular events. It is fundamental to define subtype classification (unilateral or bilateral disease), in order to provide the best treatment (surgery for unilateral and medical treatment for bilateral disease). Here, we report five clinical cases of different subtypes of PA (patients with monolateral or bilateral PA, nondiagnostic AVS, allergy to iodinated contrast, and patients not suitable for surgery), with particular attention to the diagnostic-therapeutic process and the different approaches tailored to a single case. Since PA is a spectrum of various diseases, it needs a personalized diagnostic-therapeutic process, customized for the individual patient, depending on previous medical history, suitability for the surgery and patient's preferences.
Keyphrases
- case report
- cardiovascular events
- minimally invasive
- coronary artery bypass
- blood pressure
- end stage renal disease
- healthcare
- cardiovascular disease
- magnetic resonance
- newly diagnosed
- high resolution
- chronic kidney disease
- type diabetes
- magnetic resonance imaging
- mass spectrometry
- brain injury
- peritoneal dialysis
- smoking cessation
- contrast enhanced
- replacement therapy