Screening of Hyperaldosteronism on the Investigation of Secondary Hypertension: Single-centre Experience

Introduction:Primary hyperaldosteronism (PHA), is a clinical syndrome that is defined as inappropriately increased serum aldosterone secretion and low plasma renin levels. PHA has been reported as the most common cause of secondary hypertension. In this retrospective study, we planned to show the significance of screening for this disease in hypertensive patients admitted to our clinic.Methods:Our study included 64 patients who were admitted to our cardiology outpatient clinic between April 2018 and August 2021 with high blood pressure and were selected to be checked for plasma renin activity (PRA), PAC, and PAC/PRA ratios to exclude secondary hypertension. Medical records, hypertension treatments, and medical histories of the patients were reviewed from our hospital database.Results:Of the 64 patients, 25 (39.1%) were female and 39 (60.9%) were male. After the first evaluation of the patients, 13 patients were decided to be assessed with the saline infusion test. PHA was diagnosed in 7 of 13 patients evaluated. In the adrenal MRI performed in 3 of 7 patients diagnosed with PHA, one adrenal hyperplasia and one adrenal adenoma were diagnosed in 2 different patients.Conclusion:Primary hyperaldosteronism is one of the most important causes of secondary hypertension. Although there are various methods such as screening tests, the most commonly used method is the aldosterone/renin ratio and it is very practical to screen. Considering the various cardiovascular diseases that PHA is associated with, and the simplicity of treatment of PHA, we strongly believe that the screening threshold for PHA should be kept as low as possible and should be independent of age

A Case of Spontaneous Multivessel Coronary Artery Spasm That Underwent Stent Implantation Accompanying ST Segment Elevation on Inferior Electrocardiographic Leads

Coronary artery spasm is usually defined as a focal constriction of a coronary artery segment, which is reversible, and causes myocardial ischaemia by restricting coronary blood flow. A coronary spasm may rarely compromise all three epicardial arteries simultaneously. We present a case of severe coronary spasm afflicting all coronary arteries accompanying an ST segment elevation in leads D2-D3 and aVF

Mean Platelet Volume in Heterrozygous Beta Thallassaermia

Background/Aim: It is not known why cerebrovascular and cardiovascular ischaemic events are less frequently observed in heterozygous beta thalassaemia (HBT) patients than in the general population. However, we previously reported that serum levels of some platelet function markers, i.e. soluble CD40 ligand and soluble P-selectin, are lower in patients with HBT than in controls. A high mean platelet volume (MPV) is an indicator of in vivo platelet activation and may indicate a tendency to thrombosis. We investigated whether MPV is lower in HBT patients than in controls. Methods: Forty-eight patients with HBT were compared with 51 controls matched for gender, age, and BMI for MPV in a cross-sectional study. Results: The MPV was within the normal range and higher in the HBT group (9.64 +/- 1.20 vs. 9.07 +/- 082 fL, p = 0.006). The 2 groups were similar in terms of atherosclerosis risk factors and medications. After linear regression analysis, the MPV was correlated with HBT, sensitive CRP, and BMI. Conclusion: The higher MPV in patients with HBT could indicate platelet activation, and this may repre-sent a dilemma. Higher MPV in the HBT group might have resulted from higher sympathetic nervous system activity, mild ineffective erythropoiesis, and haemolysis. (C) 2017 S. Karger AG, Base