Mid aortic syndrome : An unusual cause of childhood hypertension

Abstract

Mid aortic syndrome (MAS) is characterized by an extensive narrowing of the abdominal aorta, with involvement of the renal and visceral arterial branches. Angiography is the gold standard for the diagnosis of MAS. However, computed tomography angiography (CTA) can effectively determine the location and the extent of the stenosis. Medical management of MAS generally means a lifelong, combination of multiple classes of antihypertensive medications. Surgical correction such as aortoaortic bypass with renal revascularization remains the definitive treatment of the idiopathic MAS. Moreover, the surgery can provide tissues for histological examination to arrive at the definite diagnosis of MAS. We reported a case of MAS in a child with discrepancy of the blood pressure in the upper and lower extremities along with abdominal bruits. The diagnosis of MAS was confirmed by the CTA. Her blood pressure was controlled with 6 antihypertensive drugs with no serious side effects observed.