EC Paediatrics

Neonatal hypertension is a rare condition that can be asymptomatic or accompanied by nonspecific signs. We describe a case of a 7-day-old female newborn admitted to the Emergency Department with a history of poor feeding and lethargy, presenting with respiratory distress, cardiac murmur, hepatomegaly and weight loss. Sustained hypertension was present at admission. Laboratory evaluation revealed acute kidney injury and transthoracic echocardiogram showed severe left ventricular dysfunction. Despite improvement of cardiac function, antihypertensive therapy was not effective in lowering blood pressure. Etiological investigation included a renal Doppler ultrasound, showing unilateral left renal hypoperfusion, and a renal angiography revealing left renal artery stenosis. A dilatation of this stenosis via percutaneous transluminal angioplasty was performed, followed by normalization of blood pressure and progressive weaning of antihypertensive therapy. Angiography remains the gold standard test allowing both diagnosis confirmation and therapeutic intervention. Prompt diagnosis of neonatal hypertension as well as etiological investigation is essential to assure timely therapeutic institution and prevention of target organ damage.

 Keywords: Neonatal Hypertension (NHT); Blood Pressures (BP); Left Ventricular Dysfunction

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