cardiovascular disorders
Renovascular Hypertension
Symptoms and Signs of Renovascular Hypertension
Renovascular hypertension is usually asymptomatic. A systolic-diastolic bruit in the epigastrium, usually transmitted to one or both upper quadrants and sometimes to the back, is almost pathognomonic, but it is present in only about 50% of patients with fibromuscular dysplasia and is rare in patients with renal atherosclerosis. Renovascular hypertension should be suspectedif Diastolic hypertension develops abruptly in a patient<30 years or>50 years New or previously stable hypertension rapidly worsens over a period of 6 months Hypertension is initially severe (eg, systolic BP > 180 mm Hg) There is unexplained worsening renal function Hypertension is resistant to medications A history of trauma to the back or flank or acute pain in this region with or without hematuria suggests renovascular hypertension (possibly due to arterial injury), but these findings are rare. Asymmetric renal size (> 1 cm difference) discovered incidentally during imaging tests, and recurrent episodes of unexplained acute Pulmonary Edema or 