Abstract:
Background. Carotid stenosis is diagnosed in 25% of hypertensive patients, more
commonly in men over 50 years old. Interventional treatment facilitates the prognosis of
patients. Hypertensive emergency and ineffective response to antihypertensive treatment
may be influenced by carotid artery stenosis.
Objective(s). Presentation and analysis of the clinical case of the patient (man, smoker) with
uncontrolled hypertension, hypertensive emergency and severe stenosis of the carotid
artery.
Materials and methods. Man, 66 years old, urgently hospitalized in the Cardiology
Department CMH "Holy Trinity" with BP 240/110 mmHg, FCC 62 b/min. Clinical and
paraclinical data were obtained from the discussion with the patient and the medical record.
Patient was investigated on ECOCG, duplex-color doppler of extracranial vessels, hematological, biochemical blood tests.
Results. Paraclinical: ECG sinusal rhythm with FCC 60 b/min. Signs of left ventricular
hypertrophy. EcoCG: severe concentric left ventricular hypertrophy; EF 67%. Duplex of
brachiocephalic vessels: obliterating atherosclerosis with bilateral artery damage. On the
right: stenosis ACC 20%, carotid bulb – 35%, ACI – 65%, ACE – 25% on the left: stenosis ACC
– 20%, carotid bulb – 80%, ACI – 50% general analysis of urine and blood within normal
limits, dyslipidemia. Combined treatment with ARB, CCB, diuretic, antiaggregants, statins.
Surgical intervention: percutaneous transluminal angioplasty of the left carotid artery with
its stenting.
Conclusion(s). Ineffective antihypertensive treatment, complicated by hypertensive
emergencies, may be caused by carotid stenosis. Smoking patients with hypertension and
dyslipidemia require Doppler of extracranial vessels to detect carotid artery stenosis and its
interventional treatment.
