Management of Hypertensive Emergency in the Setting of Primary Aldosteronism Complicated by Heart Failure With Reduced Ejection Fraction

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2023 Nov 29

PMID 38021907

Authors

Tauseef Sarguroh

Aliziya Punjwani

Affiliations

Soon will be listed here.

Abstract

We present a case of a 49-year-old man with a past medical history of uncontrolled hypertension and alcohol use disorder presently in sustained remission who presented to the ED with shortness of breath. He was admitted for the management of hypertensive emergency and hypokalemia and was later found to have primary aldosteronism complicated by heart failure with reduced ejection fraction. The patient's treatment-resistant hypertension as well as hypokalemia, which was refractory to repletion, resolved with mineralocorticoid-receptor-antagonist pharmacotherapy. After a single oral dose of spironolactone 25 mg, the patient's mean arterial pressure decreased by approximately 26.5%. Spironolactone 25 mg was continued twice daily not only as the mainstay treatment for primary aldosteronism but also to optimize guideline-directed medical therapy for the treatment of heart failure with reduced ejection fraction.

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