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An unusual cardiovascular triad: Renal artery stenosis, aortic dissection and dilated cardiomyopathy in a young male

Cherie Lamb, Cinnamon Bradley, Chinedu Ivonye

Am J Case Rep 2009; 10:5-8

ID: 869533

Background: Renal Artery Stenosis (RAS) is classically a disease of young females with fibromuscular dysplasia(FMD) or elderly males with atherosclerosis. Although RAS can cause uncontrolled hypertension and lead to aortic dissection, there are few case reports of these two entities occurring with dilated cardiomyopathy in young patients. We present an unusual case of renal artery stenosis, aortic dissection and dilated cardiomyopathy in a young African male.
Case Report: A 22-year-old African male with no significant past medical history presented to the emergency room with chest pain, shortness of breath and hypertensive crisis. Workup revealed a dilated cardiomyopathy, bilateral RAS with collateral circulation, an abdominal aortic aneurysm and an aortic dissection. The etiology of his RAS was thought to be congenital as a definitive cause was not elicited. The patient later underwent surgical repair of his aortic and renal vasculature.
Conclusions: This is a rare presentation of RAS because it strays from the classical presenting group of young females with fi bromuscular dysplasia and elderly males with atherosclerosis. In addition, there are few cases eliciting the triad of RAS, aortic dissection and dilated cardiomyopathy in a young black male.

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