Hipertensão refratária em paciente com aorta em recife de coral: um relato de caso

Abstract

Introduction: Coral reef aorta (ARC) is a relatively uncommon vascular pathology, with the formation of coarse atherosclerotic plaques and irregular calcification that grow towards the lumen of the aorta and cause stenosis with a reduction in the overall caliber of the vessel, which may have repercussions hemodynamics. Case Report: Patient female, 73 years old, with hypertensive encephalopathy refractory to sodium nitroprusside and nitroglycerin in full doses. Presents a history of previous lameness, without trophic lesions, monitored by the clinical cardiology team. Presents only reduced bilateral femoral pulses. There is an upper and lower blood pressure discrepancy, without neurological changes. The aorto-iliac tomography angiography showed diffuse atherosclerotic disease of irregular calcified plaques, with a diffusely reduced caliber of the aorta throughout its entire length, presenting two points of significant stenosis - with a presumed diagnosis of coral-like aorta as the trigger for renovascular hypertension. She had undergone balloon angioplasty of the descending thoracic aorta and had a self-expanding stent placed; Angioplasty of the abdominal aorta was then performed with a balloon and balloon-expanding stent implantation. She was discharged on the eighth postoperative day, with controlled SBP below 140mmHg and outpatient follow-up. Conclusion: Coral reef aorta is an uncommon pathology, which can present life-threatening symptoms, is still underdiagnosed and requires further studies.