Hyperaldosteronism Management

This episode reviews primary aldosteronism management, focusing on universal screening mandates and optimized pre analytic protocols to prevent false results. We break down the diagnostic workup, comparing immunoassay and mass spectrometry cutoffs, and discuss when to bypass confirmatory testing for direct lateralization. The discussion covers subtype classification using computed tomography and adrenal venous sampling, including exceptions for select young patients. Finally, we review therapeutic strategies, detailing unilateral laparoscopic adrenalectomy for lateralized disease and medical management with mineralocorticoid receptor antagonists, emphasizing the clinical importance of titrating medication doses to unmask suppressed renin levels and mitigate adverse long term cardiovascular tissue damage.