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We report the case of a 75-year old woman who presented with shortness of breath and haemoptysis. She had been treated for presumed essential hypertension for many years. On admission she was found to be severely hypertensive. Chest X-ray showed pulmonary oedema. However, an echocardiogram reported good systolic ventricular function. Her hypertension and pulmonary oedema did not respond to medical treatment necessitating intubation. A CT angiogram identified the cause--undiagnosed bilateral severe. We discuss this increasingly common condition that is difficult to manage and easily missed.


Journal article


Acute Med

Publication Date





23 - 25


Acute Disease, Aged, Diagnosis, Differential, Dyspnea, Echocardiography, Essential Hypertension, Fatal Outcome, Female, Hemoptysis, Humans, Hypertension, Pulmonary Edema, Renal Artery Obstruction, Tomography, X-Ray Computed, Ventricular Function, Left