Aortic coarctation

Case contributed by Dr Suraindra Mark Rajadurai

Presentation

Initially presented with longstanding exertional dyspnea.

Patient Data

Age: 20 years
Gender: Female
X-ray

Pre-operative study

Prominence of the aortic knuckle with a classic figure 3 sign as well as bilateral rib notching

CT

Pre-operative study

CT demonstrates focal aortic narrowing distal to the left subclavian artery as well as numerous dilated body wall and intercostal collaterals.  

Case Discussion

In developed countries most cases of aortic coarctation are diagnosed in children with surgical repair early in life, precluding the development of significant collaterals.

In this case, the patient was only diagnosed in adulthood due to symptoms of exertional dyspnea resulting in the classic appearance of rib notching on the chest radiograph. 

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