An Unexpected Cause of Severe Hypertension and Bradycardia: The Role of Hemodynamic Assessment by Echocardiography

Gard M. S. Myrmel, Abukar Ali, Torbjørn Lunde, Giuseppe Mancia, Sahrai Saeed

PULSE · 2022-yil

Annotatsiya

Severe hypertension has numerous etiologies. When accompanied by bradycardia, the spectrum of differential diagnoses is greatly narrowed and is commonly seen in patients with increased intracranial pressure. However, other etiologies such as bradycardia-induced hypertension are rarely mentioned. Here we report the case of a 73-year-old woman presenting with symptoms of heart failure, severe hypertension, and bradycardia with a 2:1 atrioventricular block. Echocardiography demonstrated increased left ventricular filling secondary to bradycardia and prolonged diastole, leading to greater ventricular stretch, increased contractile force and greater stroke volume (Frank-Starling mechanism), which subsequently caused elevated systolic blood pressure (BP), low diastolic BP and a wide pulse pressure. Treating the bradycardia by pacing led to an immediate and substantial BP reduction, although complete BP normalization had a slower time course and was probably due to the concomitant effect of the antihypertensive treatment initiation. This pathophysiological mechanism has received little attention in the literature. Further, stimulation of sympathetic afferents located in the heart by distension of the cardiac walls as well as the role of vagally innervated cardiopulmonary receptors due to the increased pressure in the heart and the pulmonary artery should also be kept in mind as alternative hypotheses.

Maqola ma’lumotlari
MualliflarGard M. S. Myrmel, Abukar Ali, Torbjørn Lunde, Giuseppe Mancia, Sahrai Saeed
JurnalPULSE
NashriyotPROFI университетининг
ISSN2074-1855, 2235-8668
Nashr sanasi2022-01-01
Jild10
Son1-4
Betlar46-51
TilIngliz
Ilmiy sohaPsixologiya
DOI10.1159/000525078
Indeksga qo‘shilgan2026-09-02

DOI: 10.1159/000525078 · Maqolaning asl sahifasi

Ilmiy soha

Psixologiya

Iqtibos keltirish

APAGard M. S. Myrmel, Abukar Ali, Torbjørn Lunde, Giuseppe Mancia, & Sahrai Saeed (2022). An Unexpected Cause of Severe Hypertension and Bradycardia: The Role of Hemodynamic Assessment by Echocardiography. PULSE, 10(1-4), 46-51. https://doi.org/10.1159/000525078
GOST (OAK)Gard M. S. Myrmel va b. An Unexpected Cause of Severe Hypertension and Bradycardia: The Role of Hemodynamic Assessment by Echocardiography // PULSE. – 2022. – T. 10, № 1-4. – P. 46-51. – DOI: 10.1159/000525078.
MLAGard M. S. Myrmel, Abukar Ali, Torbjørn Lunde, Giuseppe Mancia, and Sahrai Saeed. “An Unexpected Cause of Severe Hypertension and Bradycardia: The Role of Hemodynamic Assessment by Echocardiography.” PULSE, 10(1-4), 46-51, 2022. https://doi.org/10.1159/000525078
ChicagoGard M. S. Myrmel, Abukar Ali, Torbjørn Lunde, Giuseppe Mancia, and Sahrai Saeed. “An Unexpected Cause of Severe Hypertension and Bradycardia: The Role of Hemodynamic Assessment by Echocardiography.” PULSE, 10(1-4), 46-51 (2022). https://doi.org/10.1159/000525078
HarvardGard M. S. Myrmel, Abukar Ali, Torbjørn Lunde, Giuseppe Mancia, and Sahrai Saeed (2022) ‘An Unexpected Cause of Severe Hypertension and Bradycardia: The Role of Hemodynamic Assessment by Echocardiography’, PULSE, 10(1-4), 46-51. https://doi.org/10.1159/000525078
BibTeX
@article{gardmsmyrmel2022,
  title = {An Unexpected Cause of Severe Hypertension and Bradycardia: The Role of Hemodynamic Assessment by Echocardiography},
  author = {Gard M. S. Myrmel and Abukar Ali and Torbjørn Lunde and Giuseppe Mancia and Sahrai Saeed},
  journal = {PULSE},
  year = {2022},
  volume = {10},
  number = {1-4},
  pages = {46-51},
  doi = {10.1159/000525078},
  url = {https://doi.org/10.1159/000525078}
}

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