Resistant Hypertension Secondary to Renal Arteriovenous Malformation: A Case of Cure After Nephrectomy.
Alexis Garza, Maximo Alvarez, Paul Kim et al.
✦ AI-curated · Sources linked
Case in brief
A 33-year-old woman with longstanding uncontrolled hypertension requiring five antihypertensive agents was evaluated for refractory blood pressure control. Imaging revealed a large congenital renal arteriovenous malformation (rAVM). Due to its size and complexity, endovascular treatment was not feasible, leading to elective nephrectomy. Post-surgery, the patient showed significant improvement in blood pressure, eliminating the need for medication.
What made this case unusual
The case highlights hypertension as the primary manifestation of a renal arteriovenous malformation, which is uncommon compared to typical presentations like hematuria or flank pain.
Diagnostic / clinical pearl
Clinicians should consider congenital renal vascular malformations in young patients with resistant hypertension, as they can be a rare but significant underlying cause.
Why it matters
This case underscores the importance of surgical intervention in cases where endovascular options are not viable, providing a potential cure for patients with severe drug-resistant hypertension.