AN INTERESTING CASE OF SECONDARY HYPERTENSION-A CASE REPORT

INTRODUCTION- Renovascular hypertension is an important cause of secondaryhypertension. Renal artery stenosis is commonly caused by atherosclerosis (in 90 percentage ofcases) and fibromuscular dysplasia (in 10 percentage of cases).CASE PRESENTATION- A youngfemale aged 20 years was admitted with giddiness and hypertension. Clinically she had right renalartery bruit . On evaluation found to have unilateral contracted right kidney in ultrasound. Dopplerstudy showed dampened flow and increased acceleration time in right renal artery. Subsequent CTangiogram revealed right renal artery stenosis in the proximal segment.Diuretic renal study showedreduced size, perfusion and function of right kidney. Hypertension was easily controlled withantihypertensive drugs and she was referred to higher centre for surgical correction.CONCLUSION -Fibromuscular dysplasia is the most common cause of renovascular stenosis in patients less than 40years especially in females, typically presenting as hypertension. Incontrast to atherosclerotic renal artery stenosis , fibromuscular dysplasia is often cured by angioplasty.