Mineralcorticoid Excess

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clinical causes
clinical manifestations
anesthetic management

Clinical causes:

Primary aldosteronism:
-unilateral adrenal adenoma
-bilateral adrenal hyperplasia
-adenoma carcinoma

Secondary aldosteronism:
-congestive heart failure
-cirrhosis
-nephrotic syndrome

Clinical manifestations:

-hypertension
-hypervolemia
-muscle weakness
-metabolic alkalosis
-hypokalemia

Anesthetic management:

Fluid disturbance:
-hypervolemia, secondary to increased Na+ reabsorption and H20 following
-assess orthostatic hypotension
-PAC helps to assess LV filling pressures (LVEDP)
electrolyte disturbance
-hypokalemia

Treatment with spirinolactone:
-aldosterone antagonist
-K+ sparring