RESUMO
El síndrome de aorta media (SAM) consiste en una estenosis de la aorta abdominal generalmente con inclusión de las arterias renales y viscerales. Es un síndrome muy infrecuente (0,5-2%), aunque una causa importante de hipertensión arterial (HTA) en niños y adolescentes. Se cree que su origen embriológico se debe a un fallo en la fusión de las dos aortas dorsales y la etiología es idiopática en un alto porcentaje. Su localización es interrenal en el 54% de los casos. Clínicamente cursa con HTA, sintomática o no. A la exploración puede apreciarse soplo abdominal, pulsos femorales disminuidos o ausentes y diferencia de TA entre miembros superiores e inferiores. La angiografía es considerada la técnica de elección aunque las técnicas angiográficas no invasivas mediante RM y TC se encuentran al mismo nivel diagnóstico. La ecografía es la primera técnica de despistaje. El tratamiento médico consiste en la combinación de diferentes antihipertensivos. El tratamiento quirúrgico puede ser curativo(AU)
The middle aortic syndrome (MAS) is caused by stenosis of the abdominal aorta, often accompanied by concomitant stenosis of the renal or visceral arteries. Although MAS is uncommon (0.5-2%), it is an important cause of hypertension in children and adolescents. It is thought to originate in a failure of the two dorsal aortas to fuse during embryological development, and a high percentage of cases are idiopathic. MAS affects the segment of the aorta between the renal arteries in 54% of cases. Clinically, it courses with symptomatic or asymptomatic arterial hypertension. On physical examination, findings include an abdominal bruit, diminished or absent femoral pulses, and a difference between the arterial pressure of the upper and lower limbs. Angiography is the technique of choice, although noninvasive MR angiography and CT angiography have similar diagnostic accuracy. Ultrasonography is the primary screening technique. Medical treatment consists of a combination of different antihypertensives. Surgical treatment can be curative(AU)
Assuntos
Humanos , Masculino , Criança , Adolescente , Doenças da Aorta , Estenose Aórtica Subvalvar , Estenose da Valva Aórtica , Angiografia Coronária/instrumentação , Angiografia Coronária/métodos , Angiografia Coronária , Angiografia por Ressonância Magnética/instrumentação , Angiografia por Ressonância Magnética/métodos , Aorta/patologia , Aorta , Angiografia/instrumentação , Angiografia/métodos , Angiografia , Hipertensão , Ultrassonografia Doppler em Cores/instrumentação , Ultrassonografia Doppler em Cores/métodos , Ultrassonografia DopplerRESUMO
The middle aortic syndrome (MAS) is caused by stenosis of the abdominal aorta, often accompanied by concomitant stenosis of the renal or visceral arteries. Although MAS is uncommon (0.5-2%), it is an important cause of hypertension in children and adolescents. It is thought to originate in a failure of the two dorsal aortas to fuse during embryological development, and a high percentage of cases are idiopathic. MAS affects the segment of the aorta between the renal arteries in 54% of cases. Clinically, it courses with symptomatic or asymptomatic arterial hypertension. On physical examination, findings include an abdominal bruit, diminished or absent femoral pulses, and a difference between the arterial pressure of the upper and lower limbs. Angiography is the technique of choice, although noninvasive MR angiography and CT angiography have similar diagnostic accuracy. Ultrasonography is the primary screening technique. Medical treatment consists of a combination of different antihypertensives. Surgical treatment can be curative.