Sodium Nitroprusside Treatment for Control of Decompensated Heart Failure

Hypertensive crisis is thought to be initiated by an abrupt increase in systemic vascular resistance, likely related to humoral vasoconstrictors. Left ventricular dilatation and failure may develop as a result of increased afterload due to hypertension. Left heart failure may result in secondary pulmonary hypertension by increasing pulmonary venous pressure. Here, we report the effects of sodium nitroprusside for treatment of hypertensive crisis complicated with acute left ventricular dilatation, heart failure, and pulmonary hypertension secondary to vesicoureteral reflux in a 10-year-old female patient. This article presents a complex clinical case treated by simple medication

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1. Yang WC, Zhao LL, Chen CY, Wu YK, Chang YJ, Wu HP. First-attack pediatric hypertensive crisis presenting to the pediatric emergency department. BMC Pediatr. 2012;12:200.

2. Chandar J, Zilleruelo G. Hypertensive crisis in children. Pediatr Nephrol. 2012;27(5):741– 51.

3. Singh D, Akingbola O, Yosypiv I, El-Dahr S. Emergency management of hypertension in children. Int J Nephrol. 2012;2012:420247. Epub 2012 Apr 19.

4. Varlam DE, Dippell J. Non-neurogenic bladder and chronic renal insufficiency in childhood. Pediatr Nephrol. 1995;9(1):1–5.

5. Wirbelauer J, Strotmann J, Kirchhoff A, Darge K, Thomas W. Hypertensive crisis in infancy and childhood. Klin Padiatr. 2008;220(4):243–7.

6. Gordillo-Paniagua G, Velásquez-Jones L, Martini R, Valdez-Bolaños E. Sodium nitroprusside treatment of severe arterial hypertension in children. J Pediatr. 1975;87(5):799–802.

7. Konstam MA, Salem DN, Isner JM, Zile MR, Kahn PC, Bonin JD, Cohen SR, Levine HJ. Vasodilator effect on right ventricular function in congestive heart failure and pulmonary hypertension: endsystolic pressure-volume relation. Am J Cardiol. 1984;54(1):132–6.

8. Torres Macho J, Delgado Jimenez JF, Sanz Salvo J, Gonzalez Mansilla A, Sanchez Sanchez V, Gamez Diez S, Escribano Subias P, Saenz de la Calzada C. Effect of different pharmacologic agents to reverse severe pulmonary hypertension among end-stage heart failure patients. Transplant Proc. 2009;41(6):2477–9.