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PEDIATRICS Vol. 107 No. 1 January 2001, pp. 185-186

EXPERIENCE AND REASON:
Perinatal Renal Ischemia Resulting in Hypertensive Cardiomyopathy

Received Apr 26, 2000; accepted Jul 12, 2000.

Jeffrey M Saland*

Lynn Mahony*

Michel Baum*, Dagger

Departments of * Pediatrics and Dagger  Internal Medicine University of Texas Southwestern Medical Center Dallas, TX 75390-9063

Three neonates presented with malignant hypertension during the first week of life; 2 of them had congestive heart failure. Although none had indwelling umbilical artery catheters, unilateral renovascular lesions were diagnosed by nuclear perfusion scans. Angiotensin-converting enzyme inhibitor therapy produced rapid recovery. Hypertension must be included in the differential diagnosis of infants presenting with congestive heart failure and acidosis. Ultrasonography is not sensitive enough to exclude renovascular lesions. We emphasize the importance of early diagnosis and treatment.

 Key words:  neonatal, renovascular hypertension, congestive heart failure, converting enzyme inhibitors, renal artery stenosis.




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