Unmasking of Neonatal Renovascular Hypertension by Milrinone Used for Cardiac Dysfunction
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Prema Ramaswamy • Susan Schulman • Panayot Filipov • Juan C. Kupferman
- چاپ و سال / کشور: 2011
Description
A neonate initially presented with heart failure, with severe cardiac dysfunction confirmed by echocardiography, at 3 days of age. Blood pressure at presentation was in the high normal range. It was not until there was a rapid improvement of left-ventricular function on intravenous milrinone that the infant was noted to be hypertensive on day of life 7. It is noteworthy that milrinone, a drug with vasodilator and inotropic properties, paradoxically unmasked hypertension by rapidly improving left-ventricular function. Subsequent work-up showed the etiology of hypertension to be left renal artery stenosis. We present this case to alert clinicians to the rarer causes of left-ventricular dysfunction and to point out that its etiology, i.e., hypertension, may not be apparent until there is improvement in the systolic function of the left ventricle.
Pediatr Cardiol DOI 10.1007/s00246-011-0027-4 Received: 15 January 2011 / Accepted: 20 May 2011
