Presentation
Initially presented with longstanding exertional dyspnea.
Patient Data
Age: 20 years
Gender: Female
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Frontal
Prominence of the aortic knuckle with a classic figure 3 sign as well as bilateral rib notching.
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Axial C+ arterial phase
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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