Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Piani, F; Landolfo, M; Fiorini, G; D'Addato, S; Mancia, G; Borghi, C.
Severe impaired blood pressure control caused by baroreflex failure as a late sequela of neck irradiation.
J Hypertens. 2020; 38(3):553-556
Doi: 10.1097/HJH.0000000000002286
(- Case Report)
PubMed
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- Abstract:
- : A 64-year-old man, whose medical history was significant only for locally advanced squamocellular carcinoma of the right palatine tonsil treated with extended neck radiotherapy 9 years before, was evaluated for traumatic cerebral haemorrhage secondary to syncope after a postural change. The selective angiographic study of cerebral vessels was negative. No heart arrhythmias were recorded at ECG monitoring. The 24-h ABPM revealed sudden pressor and depressor episodes during day-time and a reverse dipper pattern during night-time. Noninvasive autonomic nervous system function testing showed supine hypertension and orthostatic hypotension caused by afferent baroreflex failure. According to literature, even if only few cases are described, neck irradiation can be assumed to be the major cause of baroreflex failure. No treatment is currently approved. The patient was treated with a selective beta-blocker (bisoprolol) administered at bedtime. Repeated ABPM after 1 month of therapy showed absence of sudden pressor and depressor episodes and no dipper pattern during night-time.
- Find related publications in this database (using NLM MeSH Indexing)
- Antihypertensive Agents - therapeutic use
- Baroreflex - radiation effects
- Bisoprolol - therapeutic use
- Blood Pressure - radiation effects
- Humans - administration & dosage
- Hypertension - drug therapy, etiology
- Hypotension, Orthostatic - etiology
- Male - administration & dosage
- Middle Aged - administration & dosage
- Radiotherapy - adverse effects
- Tonsillar Neoplasms - radiotherapy