Hipertensión renovascular en el niño
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1988
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
La hipertensión arterial y sus complicaciones constituyen un capítulo que erróneamente es con frecuencia soslayado y subestimado dentro de la patología pediátrica, pero que en realidad es una causa de enfermedad que debe tenerse siempre en los niños. Por otra parte en pediatría, la proporción de hipertensión secundaria o de etiología conocida es mayor en relación al total de casos de hipertensión que en el adulto, lo que quiere decir que debe buscarse con tenacidad la causa de fondo de la hipertensión en los niños, pues con cierta frecuencia se la halla; y dentro de las hipertensiones secundarias, la renovascular es una de las más frecuentes. Los argumentos arriba señalados justifican por demás el conocimiento de la hipertensión en el infante, y de su variedad vasculorenal, y son razones suficientes para motivar el interés del médico en este tema, que es el de mi trabajo monográfico que expondré a continuación. En él he tenido como lema a todo lo largo de la obra la exposición ordenada, lógica y sistematizada, mostrando la forma correcta de valerse de los datos obtenidos del paciente, para ir sacando conclusiones e ir aclarando y puntualizando los diferentes tópicos del tema; así, primero agoto la Semiología y la Clínica, para llegar al diagnóstico del padecimiento, tanto sindrómico como etiológico; luego explico los mecanismos de la enfermedad diagnosticada, es decir la fisiopatología; a continuación, reseño el tratamiento, objetivos final de la labor del médico ante un paciente, conjuntamente con la educación y el consejo en salud para el paciente y su familia, lo que debe ser parte integrante de la actuación del médico para con sus enfermos; finalmente, considero el seguimiento que debe tener este paciente, lo que es fundamental para el éxito terapéutico, pues me permite evaluar el padecimiento con la periodicidad requerida para poder realizar los ajustes terapéuticos convenientes y en forma oportuna.
Arterial hypertension and its complications constitute a chapter that is often mistakenly overlooked and underestimated in pediatric pathology, but which in reality is a cause of disease that must always be taken in children. On the other hand, in pediatrics, the proportion of secondary hypertension or of known etiology is greater in relation to the total number of cases of hypertension than in the adult, which means that the underlying cause of hypertension in children must be sought with tenacity, for it is found with a certain frequency; and within secondary hypertension, renovascular is one of the most frequent. The above-mentioned arguments justify the knowledge of hypertension in the infant, and its vasculorenal variety, and are sufficient reasons to motivate the interest of the doctor in this subject, which is the one of my monographic work that I will expose next. In it I have had throughout the work as a motto the orderly, logical and systematized exhibition, showing the correct way to use the data obtained from the patient, to draw conclusions and clarify and clarify the different topics of the topic; thus, first I exhaust the Semiology and the Clinic, to arrive at the diagnosis of the illness, both syndromic and etiological; then I explain the mechanisms of the diagnosed disease, that is, the pathophysiology; Next, I outline the treatment, final objectives of the doctor's work before a patient, together with education and health advice for the patient and his family, which should be an integral part of the doctor's action towards his patients; finally, I consider the follow-up that this patient must have, which is fundamental for therapeutic success, since it allows me to evaluate the condition with the periodicity required to be able to make the appropriate therapeutic adjustments and in a timely manner.
Arterial hypertension and its complications constitute a chapter that is often mistakenly overlooked and underestimated in pediatric pathology, but which in reality is a cause of disease that must always be taken in children. On the other hand, in pediatrics, the proportion of secondary hypertension or of known etiology is greater in relation to the total number of cases of hypertension than in the adult, which means that the underlying cause of hypertension in children must be sought with tenacity, for it is found with a certain frequency; and within secondary hypertension, renovascular is one of the most frequent. The above-mentioned arguments justify the knowledge of hypertension in the infant, and its vasculorenal variety, and are sufficient reasons to motivate the interest of the doctor in this subject, which is the one of my monographic work that I will expose next. In it I have had throughout the work as a motto the orderly, logical and systematized exhibition, showing the correct way to use the data obtained from the patient, to draw conclusions and clarify and clarify the different topics of the topic; thus, first I exhaust the Semiology and the Clinic, to arrive at the diagnosis of the illness, both syndromic and etiological; then I explain the mechanisms of the diagnosed disease, that is, the pathophysiology; Next, I outline the treatment, final objectives of the doctor's work before a patient, together with education and health advice for the patient and his family, which should be an integral part of the doctor's action towards his patients; finally, I consider the follow-up that this patient must have, which is fundamental for therapeutic success, since it allows me to evaluate the condition with the periodicity required to be able to make the appropriate therapeutic adjustments and in a timely manner.
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Hipertensión renovascular, Pediatría, Hospital de Niños Alejandro Mann, Cantón Guayaquil, Ecuador, Registros médicos