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Perioperative hypertension due to undiagnosed aortic coarctation: are current standards of care adequate?
Author(s) -
Rose Michael,
Murrell David
Publication year - 2004
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.2003.01233.x
Subject(s) - medicine , coarctation of the aorta , blood pressure , perioperative , clonidine , surgery , medical history , parotidectomy , population , physical examination , intensive care medicine , general surgery , pediatrics , anesthesia , aorta , environmental health , facial nerve
Summary A 12‐year‐old male presented for a superficial parotidectomy for chronic parotitis. The patient had an unremarkable past medical history and was admitted on the day of surgery for his procedure without further anaesthetic or surgical review. During the patient's intraoperative course, higher than expected blood pressures were noted and treated with clonidine. After further high blood pressure readings in the postoperative care unit, close surveillance of blood pressures for the following 24 h was arranged. The hypertension was ongoing, and further examination and investigation confirmed the diagnosis of coarctation of the aorta. We examine the possible reasons for failure to diagnose this patient's hypertension preoperatively and suggest that there is a need for greater surveillance of blood pressures in the paediatric population presenting for surgery. A discussion of the significance of hypertension in paediatrics and recommendations for minimum standards of care to address shortcomings in the diagnosis and treatment of paediatric hypertension are proposed.