Limits...
Serendipitous diagnosis of aortic coarctation by bilateral parvus et tardus renal Doppler flow pattern.

Tarzamni MK, Nezami N, Ardalan MR, Etemadi J, Noshad H, Samani FG, Toufan M - Cardiovasc Ultrasound (2007)

Bottom Line: Diagnosis of AC is made during routine physical examination by detection of Blood Pressure (BP) difference between arm and leg.All met the following inclusion criteria: 1) arterial hypertension at age <30 years; 2) referred for renal DU to rule out renovascular hypertension.Careful physical examination should be performed in all hypertensive patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran. Tarzamni@yahoo.com

ABSTRACT

Background: Aorta Coarctation (AC) is uncommon condition that in most adult patients is asymptomatic. Diagnosis of AC is made during routine physical examination by detection of Blood Pressure (BP) difference between arm and leg.

Aim: To describe a novel renal artery Doppler flow pattern pathognomonic of aortic coarctation.

Methods: We enrolled 4 consecutive patients referred to renal artery Doppler Ultrasonography (DU) for diagnostic work-up of secondary arterial hypertension. All met the following inclusion criteria: 1) arterial hypertension at age <30 years; 2) referred for renal DU to rule out renovascular hypertension.

Results: We found in all 4 patients (age range 10 to 27 years) a bilateral "parvus-tardus" renal Doppler flow pattern. In all, echocardiographic and angiographic work-ups showed aortic coarctation.

Conclusion: Careful physical examination should be performed in all hypertensive patients. Furthermore, the suspicion of AC can be raised by a bilateral renal arteries "parvus-tardus" Doppler flow pattern in young hypertensive patients screened for secondary hypertension.

Show MeSH

Related in: MedlinePlus

(A) Schematic view of different waveforms was showed according to stenosis location (From third edition of Dignostic Ultrasound by Rumak C. M, et al.). (B) Various types of Doppler waveforms. Type A and B are normal types, but type C patterns called parvus-tardus (From second edition of Dignostic Ultrasound by Rumak C. M, et al.).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2211282&req=5

Figure 4: (A) Schematic view of different waveforms was showed according to stenosis location (From third edition of Dignostic Ultrasound by Rumak C. M, et al.). (B) Various types of Doppler waveforms. Type A and B are normal types, but type C patterns called parvus-tardus (From second edition of Dignostic Ultrasound by Rumak C. M, et al.).

Mentions: The second important aspect is concerning the diagnostic value of renal DU in detecting AC. The majority of sonologists introduced the dampened waveform pattern known as parvus-tardus [6]. This pattern mostly detected through on indirect assessment of arterial region located after stenosis (Fig. 4A) [8]. Tardus means slow and late and parvus means small and little. Tardus refers to the facts that systolic acceleration of the waveform is slowed, with consequent increase in time to reach the systolic peak. Parvus refers to the fact that the systolic peak is of low height, indicating slowed velocity. Poststenotic systolic peak are rounded with lengthened systolic rise time (or slow systolic acceleration time – the time in seconds from the onset of the systolic to peak systole), slower than 0.07 s. the acceleration index (the slope of systolic upstroke) is decreased to lesser than 3 m/s2 [9]. Normal and parvus-tardus waveforms were demonstrated in figure 4B. As shown, type A and B are normal patterns, whereas type C shows three schematic forms of parvus-tardus pattern.


Serendipitous diagnosis of aortic coarctation by bilateral parvus et tardus renal Doppler flow pattern.

Tarzamni MK, Nezami N, Ardalan MR, Etemadi J, Noshad H, Samani FG, Toufan M - Cardiovasc Ultrasound (2007)

(A) Schematic view of different waveforms was showed according to stenosis location (From third edition of Dignostic Ultrasound by Rumak C. M, et al.). (B) Various types of Doppler waveforms. Type A and B are normal types, but type C patterns called parvus-tardus (From second edition of Dignostic Ultrasound by Rumak C. M, et al.).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2211282&req=5

Figure 4: (A) Schematic view of different waveforms was showed according to stenosis location (From third edition of Dignostic Ultrasound by Rumak C. M, et al.). (B) Various types of Doppler waveforms. Type A and B are normal types, but type C patterns called parvus-tardus (From second edition of Dignostic Ultrasound by Rumak C. M, et al.).
Mentions: The second important aspect is concerning the diagnostic value of renal DU in detecting AC. The majority of sonologists introduced the dampened waveform pattern known as parvus-tardus [6]. This pattern mostly detected through on indirect assessment of arterial region located after stenosis (Fig. 4A) [8]. Tardus means slow and late and parvus means small and little. Tardus refers to the facts that systolic acceleration of the waveform is slowed, with consequent increase in time to reach the systolic peak. Parvus refers to the fact that the systolic peak is of low height, indicating slowed velocity. Poststenotic systolic peak are rounded with lengthened systolic rise time (or slow systolic acceleration time – the time in seconds from the onset of the systolic to peak systole), slower than 0.07 s. the acceleration index (the slope of systolic upstroke) is decreased to lesser than 3 m/s2 [9]. Normal and parvus-tardus waveforms were demonstrated in figure 4B. As shown, type A and B are normal patterns, whereas type C shows three schematic forms of parvus-tardus pattern.

Bottom Line: Diagnosis of AC is made during routine physical examination by detection of Blood Pressure (BP) difference between arm and leg.All met the following inclusion criteria: 1) arterial hypertension at age <30 years; 2) referred for renal DU to rule out renovascular hypertension.Careful physical examination should be performed in all hypertensive patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran. Tarzamni@yahoo.com

ABSTRACT

Background: Aorta Coarctation (AC) is uncommon condition that in most adult patients is asymptomatic. Diagnosis of AC is made during routine physical examination by detection of Blood Pressure (BP) difference between arm and leg.

Aim: To describe a novel renal artery Doppler flow pattern pathognomonic of aortic coarctation.

Methods: We enrolled 4 consecutive patients referred to renal artery Doppler Ultrasonography (DU) for diagnostic work-up of secondary arterial hypertension. All met the following inclusion criteria: 1) arterial hypertension at age <30 years; 2) referred for renal DU to rule out renovascular hypertension.

Results: We found in all 4 patients (age range 10 to 27 years) a bilateral "parvus-tardus" renal Doppler flow pattern. In all, echocardiographic and angiographic work-ups showed aortic coarctation.

Conclusion: Careful physical examination should be performed in all hypertensive patients. Furthermore, the suspicion of AC can be raised by a bilateral renal arteries "parvus-tardus" Doppler flow pattern in young hypertensive patients screened for secondary hypertension.

Show MeSH
Related in: MedlinePlus