Misdiagnosis of a hidden cause of hypertension: a case report

INTRODUCTION

Although essential hypertension (HTN) is the most common type of HTN, nearly 10% of patients have a secondary cause. Primary hyperaldosteronism (PHA) accounts for up to 23% of secondary HTN depending on criteria, screening methods, and the population studied.¹ Aldosterone-producing adenomas, known as Conn’s syndrome, represent nearly 30% of PHA cases.

Symptoms of PHA are nonspecific and may be easily missed, leading instead to the diagnosis of essential HTN. Two patients with a long history of HTN, hypokalaemia, and vague symptoms were followed by multiple specialties (internal medicine, cardiology, and endocrinology), but had not been diagnosed with Conn’s syndrome. Two cases are presented here as a means to raise awareness of this condition (Conn’s syndrome) among primary care practitioners (PCPs), because it is a potentially curable cause of HTN.