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Neonatal circulatory failure due to acute hypertensive crisis: clinical and echocardiographic clues
OBJECTIVE: Circulatory failure due to acute arterial hypertension in the neonatal period is rare. This study was undertaken to assess the clinical and echocardiographic manifestations of circulatory failure resulting from acute neonatal hypertensive crisis. METHODS: Neonatal and cardiology databases...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Clinics Cardive Publishing
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3721817/ https://www.ncbi.nlm.nih.gov/pubmed/23736130 http://dx.doi.org/10.5830/CVJA-2013-003 |
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author | Louw, Jacoba Brown, Stephen Eyskens, Benedicte Heying, Ruth Cools, Bjorn Gewillig, Marc Thewissen, Liesbeth Allegaert, Karel Smits, Anne Levtchenko, Elena |
author_facet | Louw, Jacoba Brown, Stephen Eyskens, Benedicte Heying, Ruth Cools, Bjorn Gewillig, Marc Thewissen, Liesbeth Allegaert, Karel Smits, Anne Levtchenko, Elena |
author_sort | Louw, Jacoba |
collection | PubMed |
description | OBJECTIVE: Circulatory failure due to acute arterial hypertension in the neonatal period is rare. This study was undertaken to assess the clinical and echocardiographic manifestations of circulatory failure resulting from acute neonatal hypertensive crisis. METHODS: Neonatal and cardiology databases from 2007 to 2010 were reviewed. An established diagnosis of circulatory failure due to neonatal hypertension before the age of 14 days was required for inclusion. Six patients were identified. RESULTS: Five patients presented with circulatory failure due to an acute hypertensive crisis. The median age at presentation was 8.5 days (range: 6.0–11.0) with a median body weight of 3.58 kg (range: 0.86–4.70). Echocardiography demonstrated mild left ventricular dysfunction [median shortening fraction (SF) 25%, range 10–30) and mild aortic regurgitation in 83% (5/6) of patients. One patient with left ventricular dysfunction (SF = 17%) had a large apical thrombus. Two patients were hypotensive, and hypertension only became evident after restoration of cardiac output. Administration of intravenous milrinone was successful, with rapid improvement of the clinical condition. Left ventricular function normalised in all survivors. CONCLUSION: Early neonatal circulatory collapse due to arterial hypertension is a rare but potentially life-threatening condition. At presentation, hypotension, especially in the presence of a dysfunctional left ventricle, does not exclude a hypertensive crisis being the cause of circulatory failure. The echocardiographic presence of mild aortic regurgitation combined with left ventricular hypocontractility in a structurally normal heart should alert the physician to the presence of underlying hypertension. |
format | Online Article Text |
id | pubmed-3721817 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Clinics Cardive Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-37218172013-08-07 Neonatal circulatory failure due to acute hypertensive crisis: clinical and echocardiographic clues Louw, Jacoba Brown, Stephen Eyskens, Benedicte Heying, Ruth Cools, Bjorn Gewillig, Marc Thewissen, Liesbeth Allegaert, Karel Smits, Anne Levtchenko, Elena Cardiovasc J Afr Cardiovascular Topics OBJECTIVE: Circulatory failure due to acute arterial hypertension in the neonatal period is rare. This study was undertaken to assess the clinical and echocardiographic manifestations of circulatory failure resulting from acute neonatal hypertensive crisis. METHODS: Neonatal and cardiology databases from 2007 to 2010 were reviewed. An established diagnosis of circulatory failure due to neonatal hypertension before the age of 14 days was required for inclusion. Six patients were identified. RESULTS: Five patients presented with circulatory failure due to an acute hypertensive crisis. The median age at presentation was 8.5 days (range: 6.0–11.0) with a median body weight of 3.58 kg (range: 0.86–4.70). Echocardiography demonstrated mild left ventricular dysfunction [median shortening fraction (SF) 25%, range 10–30) and mild aortic regurgitation in 83% (5/6) of patients. One patient with left ventricular dysfunction (SF = 17%) had a large apical thrombus. Two patients were hypotensive, and hypertension only became evident after restoration of cardiac output. Administration of intravenous milrinone was successful, with rapid improvement of the clinical condition. Left ventricular function normalised in all survivors. CONCLUSION: Early neonatal circulatory collapse due to arterial hypertension is a rare but potentially life-threatening condition. At presentation, hypotension, especially in the presence of a dysfunctional left ventricle, does not exclude a hypertensive crisis being the cause of circulatory failure. The echocardiographic presence of mild aortic regurgitation combined with left ventricular hypocontractility in a structurally normal heart should alert the physician to the presence of underlying hypertension. Clinics Cardive Publishing 2013-04 /pmc/articles/PMC3721817/ /pubmed/23736130 http://dx.doi.org/10.5830/CVJA-2013-003 Text en Copyright © 2010 Clinics Cardive Publishing http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Cardiovascular Topics Louw, Jacoba Brown, Stephen Eyskens, Benedicte Heying, Ruth Cools, Bjorn Gewillig, Marc Thewissen, Liesbeth Allegaert, Karel Smits, Anne Levtchenko, Elena Neonatal circulatory failure due to acute hypertensive crisis: clinical and echocardiographic clues |
title | Neonatal circulatory failure due to acute hypertensive crisis: clinical and echocardiographic clues |
title_full | Neonatal circulatory failure due to acute hypertensive crisis: clinical and echocardiographic clues |
title_fullStr | Neonatal circulatory failure due to acute hypertensive crisis: clinical and echocardiographic clues |
title_full_unstemmed | Neonatal circulatory failure due to acute hypertensive crisis: clinical and echocardiographic clues |
title_short | Neonatal circulatory failure due to acute hypertensive crisis: clinical and echocardiographic clues |
title_sort | neonatal circulatory failure due to acute hypertensive crisis: clinical and echocardiographic clues |
topic | Cardiovascular Topics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3721817/ https://www.ncbi.nlm.nih.gov/pubmed/23736130 http://dx.doi.org/10.5830/CVJA-2013-003 |
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