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Renal Artery Stenosis Emerged After Angiotensin-Converting Enzyme Inhibitor Treatment for Myocardial Infarction

A Case Report

First Department of Medicine, Asahikawa Medical College, Asahikawa, Japan, ft-park{at}asahikawa-med.ac.jp

Naoyuki Hasebe, MD

First Department of Medicine, Asahikawa Medical College, Asahikawa, Japan

Yuji Ogawa, MD

First Department of Medicine, Asahikawa Medical College, Asahikawa, Japan

Shiro Tsuji, MD

First Department of Medicine, Asahikawa Medical College, Asahikawa, Japan

Shinsuke Kido, MD

First Department of Medicine, Asahikawa Medical College, Asahikawa, Japan

Tamio Aburano, MD

Department of Radiology, Asahikawa Medical College, Asahikawa, Japan

Kenjiro Kikuchi, MD

First Department of Medicine, Asahikawa Medical College, Asahikawa, Japan

A 76-year-old woman with acute myocardial infarction underwent percutaneous coronary angioplasty followed by treatment with an angiotensin-converting enzyme (ACE) inhibitor, lisinopril. Her renal function deteriorated after the administration of lisinopril, so it was changed to another ACE inhibitor, temocapril. Renography suggested a complication of severe right renal artery stenosis, and renal angiography revealed bilateral renal artery stenoses. Her renal hemodynamics were assessed by ^99mTc-Mercaptoacetyltriglycine (^99mTc-MAG₃)-renography before and after withdrawal of temocapril. The authors concluded the patient had essential hypertension complicated by atherosclerotic renovascular disease. In the treatment of elderly patients with heart disease, hypertension, or both, with ACE inhibitor, the possibility of coexisting renal artery stenosis should be considered. Renography is recommended as a reliable tool for detecting renal artery stenosis.

Angiology, Vol. 56, No. 3, 347-350 (2005)
DOI: 10.1177/000331970505600318


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