Shock cardiogénico por emergencia hipertensiva en un neonato

Alejandro Donoso F., Jorge Camacho A., Pablo Cruces R.

Resultado de la investigación: Contribución a una revistaArtículorevisión exhaustiva

Resumen

Introduction: Neonatal arterial hypertension is unusual, mainly in previously healthy newborn children. Clinical presentations vary widely and, in some cases, it is a dramatic life-threatening event. Case report: A 6 days-old girl admitted to intensive care unit with severe cardiogenic shock and metabolic acidosis. Mechanical ventilation was initiated and inotropic support administered due to low systolic function (shortening fraction = 20%). After initial improvement, severe arterial hypertension was evidenced (systolic pressure 50 mmHg above 95 percentile). She had no umbilical catheterization. Renal doppler was normal. Laboratory analysis showed low platelet count and a raised D-dimer. Technecium 99-MAG 3 renal scan showed a decrease in renal flow in the upper right kidney, although magnetic angioresonance was normal. Myocardial function and arterial pressure returned to normal after digital and angiotensin-converting enzyme inhibitor therapy. After infections, low blood flow and anatomic causes were excluded, a believe that a perinatal microangiopathic event may lead to renal lesions with renovascular hypertension. Conclusion: Arterial hypertension must be included in the differential diagnosis of newborns with heart failure and acidosis, due to its severe clinical evolution and specific therapy.

Título traducido de la contribuciónCardiogenic shock due to hypertensive emergency in a newborn
Idioma originalEspañol
Páginas (desde-hasta)501-506
Número de páginas6
PublicaciónRevista Chilena de Pediatria
Volumen76
N.º5
EstadoPublicada - oct 2005

Palabras clave

  • Arterial hypertension
  • Cardiogenic shock
  • Hypertensive emergency
  • Newborn
  • Renovascular hypertension

Áreas temáticas de ASJC Scopus

  • Pediatría, perinaltología y salud infantil

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