Abstract 118: Primary hyperaldosteronism presenting as subarachnoid hemorrhage

Background: Primary hyperaldosteronism (PA) develops due to abnormality in the zona glomerulosa of the adrenal gland which results in excessive production of aldosterone. Primary hyperaldosteronism remains an important cause of secondary hypertension. Subarachnoid hemorrhage is a pathological condition in which the blood enters the subarachnoid space. Case Presentation: A 32 year old female presented with complains of uncontrolled hypertension on antihypertensive drugs. She gives history of a subarachnoid hemorrhage Examination revealed a BP of 170/100 mmhg which was not controlled on antihypertensive agents. Blood test showed a potassium level of 2.7 mmol/l [3.5-5 mmol/l], creatinine 0.9 mg/dl [0.7-1.4], Hb 10.5 gm/dl on the basis of the preliminary blood tests a serum Aldosterone levels were asked which showed 23.7 ng/dl [2-9 ng/dl] A CECT abdomen was done which revealed a lesion in the medial limb of the right adrenal gland. Conclusion: Primary hyperaldosteronism is an under diagnosed entity and has a higher mortality and morbidity when compared to individuals with essential hypertension. PA should be suspected in all individuals with resistant hypertension even those on multiple drugs and who develop hypokalemia.