Abdominal Murmurs, an Aid in the Diagnosis of Renal Artery Disease in Hypertension

Article1 March 1962Abdominal Murmurs, an Aid in the Diagnosis of Renal Artery Disease in HypertensionROY J. MOSER JR., M.D., JOHN R. CALDWELL, M.D.ROY J. MOSER JR., M.D., JOHN R. CALDWELL, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-3-471 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAs early as 1925, Fahr suggested that renal ischemia might be a cause of hypertension in patients with diffuse vascular disease (1). Goldblatt later provided experimental evidence of this important concept in renal artery ligation in dogs (2).In recent years, renal artery lesions frequently have been found in patients with hypertension. Some of these cases featured bruits as the only physical finding pointing to the diagnosis of renal artery aneurysm, renal arteriovenous fistula, or renal artery stenosis (3-5).Sokolow emphasized that a bruit over the upper abdominal aorta, renal arteries, or, less importantly, over the femoral arteries is one...References1. FAHR T: In Handbuch der Speziellen Pathologischen Anatomie und Histologie, vol 6, pt. 1, ed. by Henke, F., Lubarsch, O., Springer, Berlin, 1925, p. 438. Google Scholar2. GOLDBLATTLYNCHHANZALSUMMERVILLE HJRFWW: Studies on experimental hypertension. Production of persistent elevation of systolic blood pressure by means of renal ischemia. J. Exp. Med. 59: 347, 1934. CrossrefMedlineGoogle Scholar3. POUTASSEDUSTAN EFHP: Arteriosclerosis and renal hypertension, indications for aortography in hypertensive patients and results of surgical treatment of obstructive lesions of the renal artery. J. A. M. A. 165: 1521, 1957. CrossrefMedlineGoogle Scholar4. SUTTONBRUNTONSTARER DFJF: Renal artery stenosis. Clin. Radiol. (Lond.) 12: 80, 1961. CrossrefGoogle Scholar5. WYLIEWELLINGTON EJJS: Hypertension caused by fibromuscular hyperplasia of the renal arteries. Amer. J. Surg. 100: 183, 1960. CrossrefMedlineGoogle Scholar6. SOKOLOW M: In discussion of WYLIE (5). Google Scholar7. GILLILANDDELLERHALL PFJJR: A bruit due to renal artery stenosis. New Engl. J. Med. 264: 659, 1961. CrossrefMedlineGoogle Scholar8. HOWARDBERTHRONGGOULDYENDT JEMDMER: Hypertension resulting from unilateral renal vascular disease and its relief by nephrectomy. Bull. Johns Hopkins Hosp. 94: 51, 1954. MedlineGoogle Scholar9. MEYERSMURDAUGHMCINTOSHBLAINSDELL JDHVHDRK: Observations on continuous murmurs over partially obstructed arteries, explanation for the continuous murmur found in the aortic arch syndrome. Arch. Intern. Med. 97: 726, 1956. CrossrefGoogle Scholar10. BLACKMAN SS: Arteriosclerosis and partial obstruction of the main renal arteries in association with "essential" hypertension in man. Bull. Johns Hopkins Hosp. 65: 353, 1939. Google Scholar11. YUILE CL: Obstructive lesions of the main renal artery in relation to hypertension. Amer. J. Med. Sci. 207: 394, 1944. CrossrefGoogle Scholar12. LISAECKSTEINSOLOMON JRDC: Relationship between arteriosclerosis of renal artery and hypertension, analysis of 100 necropsies. Amer. J. Med. Sci. 205: 701, 1943. CrossrefGoogle Scholar13. BIRCHALLBATSONMOORE RHMCB: Hypertension due to unilateral renal arterial obstruction, preliminary observations on the contribution of differential renal clearance studies. Amer. Heart J. 56: 616, 1958. CrossrefMedlineGoogle Scholar14. DUSTANPAGEPOUTASSE HPIHEF: Renal hypertension. New Engl. J. Med. 261: 647, 1959. CrossrefMedlineGoogle Scholar15. REVELLBORGESENTWISTLEYOUNG STFJGJD: An appraisal of certain tests for the detection of hypertension of unilateral renal origin. Ann. Intern. Med. 53: 970, 1960. LinkGoogle Scholar16. WINTER CC: Unilateral renal disease and hypertension, use of radioactive Diodrast renogram as screening test. J. Urol. 78: 107, 1957. CrossrefMedlineGoogle Scholar17. BROWNOWENPEARTROBERTSONSUTTON JJKWSJID: The diagnosis and treatment of renal-artery stenosis. Brit. Med. J. 5195: 327, 1960. CrossrefGoogle Scholar18. CONNORTHOMASHADDOCKHOWARD TBWCLJE: Unilateral renal disease as a cause of hypertension, its detection by ureteral catheterization studies. Ann. Intern. Med. 52: 544, 1960. LinkGoogle Scholar19. Flow Properties of Blood and Other Biological Systems, ed. by Copley, A. L., Stainsby, G., Pergamon Press, New York, 1960, pp. 137-144. Google Scholar20. HOLMAN E: On circumscribed dilation of an artery immediately distal to a partially occluding bond: poststenotic dilation. Surgery 36: 3, 1954. MedlineGoogle Scholar21. STEHBENS WE: Turbulence of blood flow. Quart. J. Exp. Physiol. 44: 110, 1959. CrossrefMedlineGoogle Scholar22. ROBICSEK F: Post-stenotic dilation of the great vessels. Acta Med. Scand. 151: 481, 1955. CrossrefMedlineGoogle Scholar23. LITTMANN D: An approach to the ideal stethoscope. J. A. M. A. 178: 504, 1961. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROY J. MOSERJR., M.D.; JOHN R. CALDWELL, M.D.Affiliations: Detroit, MichiganFrom the Division of Hypertension, Henry Ford Hospital, Detroit 2, Michigan.Requests for reprints should be addressed to John R. Caldwell, M.D., Division of Hypertension, Henry Ford Hospital, Detroit 2, Michigan. 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WATSON, M.D., Ph.D., F.R.C.P.(G), PENELOPE BROOK WILLIAMS, M.B., C.R.C.P.(C), GERARD DUFFY, M.B.Diagnostic Significance of Abdominal MurmursClinical recognition of renal hypertensionDie renal-vasculäre HypertonieStenosing Lesions of the Renal ArteriesRenovascular HypertensionRecent advances in hypertensionRenal vascular hypertension diagnosis and treatmentA comparison of unilateral pyelonephritis and renal artery stenosis associated with hypertensionThe Pyelogram-Urea Washout TestUpper-Quadrant Bruit Due to Tortuous Splenic ArteryThe Diagnosis of HypertensionHypertension and Renovascular Disease 1 March 1962Volume 56, Issue 3Page: 471-483KeywordsAuscultationHypertensionLesionsLigation assayRenal arteriesRenal diseasesRenal ischemiaStenosisUrologyVascular diseases ePublished: 1 December 2008 Issue Published: 1 March 1962 PDF downloadLoading ...