Precise diagnosis and treatment of primary aldosteronism: a case report

This article reports the precise diagnosis and treatment of a 54-year-old male patient with primary aldosteronism (PA). The patient mainly presented with refractory hypertension, recurrent hypokalemia, palpitations and fatigue, accompanied by multiple cardiovascular target organ damages. Following the standardized procedure of screening, diagnosis, typing and lateralization, and precise intervention, the patient underwent screening by aldosterone-to-renin ratio, definite diagnosis by saline infusion test, and typing by adrenal venous sampling. After excluding Cushing syndrome, renal artery stenosis, reninoma and other diseases, the patient was finally diagnosed with right dominant secreting PA complicated with severe obstructive sleep apnea-hypopnea syndrome. His condition was significantly improved after receiving precise treatment with transcatheter adrenal artery embolization combined with medication and continuous positive airway pressure. This case indicates that establishing a standardized and precise diagnosis and treatment process for PA patients is the key to achieving early etiological diagnosis, individualized intervention and improving long-term prognosis.