“Apparent” heart failure: a syndrome caused by renal artery stenoses

OBJECTIVE To report on renal artery stenosis presenting as congestive heart failure. DESIGN Case series. SETTING Tertiary referral centre. PATIENTS Nine hypertensive subjects (five male, four female) seen in the blood pressure unit, St George's Hospital, between 1991 and 1997 with clinical signs and symptoms of congestive cardiac failure but without overt coronary or valvar heart disease. Mean (SEM) age was 67 (3) years. Eight patients had renal artery revascularisation with percutaneous angioplasty and one had surgery. RESULTS Renal revascularisation was followed by a large fall in blood pressure from 191/94 (7/3) to 150/75 (8/5) mm Hg two days after intervention (p