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Coarctation of aorta with aortic valve stenosis

Case contributed by Farhad Farzam
Diagnosis certain

Presentation

Chest pain, dyspnea, fatigue and diminished femoral pulse.

Patient Data

Age: 15 years
Gender: Male

Abrupt short-segment narrowing is demonstrated at the proximal descending thoracic aorta just distal to the origin of the left subclavian artery. The narrowed segment measured 3 mm in diameter and 1.5 mm in length.

The ascending aorta measures 38 mm in diameter. 

The descending aorta distal to the stenotic segment measured 18 mm in diameter.

The leaflets of the aortic valve are thickened. The right and left coronary cusps are fused resulting in aortic valve stenosis, which measured 6 mm in its narrowest part.

The bilateral internal thoracic arteries are dilated.

Multiple dilated collaterals are seen at the thoracic wall.

The left cardiac chambers, particularly the left ventricle, are dilated.

Left-sided aortic arch with normal branching pattern.

Case Discussion

The combination of coarctation of aorta and aortic valve stenosis is rarely seen and accounts for 5–10% of lesions resulting to obstruction of the left ventricular outflow tract.

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