Hyperaldosteronism (Conn's)

Question 1

What are the different types of hyperaldosteronism?

Answer 1

Primary = independent of renin-angiotensin axis
Secondary = due to renin ++ levels

Question 2

What are common causes of primary HA?

Answer 2

Adrenal adenoma (Conn’s Syndrome)
Adrenal carcinoma
Adrenal hyperplasia
Familial hyperaldosteronism

Question 3

What are common causes of secondary HA?

Answer 3

Malignant hypertension
Congestive heart failure
Hepatic failure
Nephrotic syndrome
Renal artery stenosis

Question 4

What are the clinical features of HA?

Answer 4

Hypertension
Headaches
Urological signs due to kidneys -- concentrating urine
-Polyuria
-Polydipsia
Hypokalaemia = weakness
Hypernatremia (or normal)
Metabolic acidosis

Question 5

How is HA investigated?

Answer 5

BLOODS

1. Aldosterone: renin ratio = >800
2. U&Es = hypokalaemia, hypernatraemia
3. ABG = metabolic acidosis

IMAGING

1. ECG = potential arrhythmias (U-waves hypokalaemia)
2. Imaging = potential tumours (adenoma)

Question 6

What is the management for HA?

Answer 6

CONN’S SYNDROME

1. Spironolactone = aldosterone antagonist (potassium sparing)
2. Adrenalectomy

SECONDARY HA
1. Treat underlying cause