Coarctation of the aorta

Case contributed by Dr Ian Bickle

Presentation

Hypertension. No known medical history.

Patient Data

Age: 35 years
Gender: Male
X-ray

Bilateral inferior rib notching.

Dilated aortic arch.

Heart size normal.  Lungs clear.

CT

Severe coarctation of the aorta with only a tiny pinhole-like communication at the site of coarctation. Extensive collateralisation of the entire upper thoracic intercostal circulation as well as internal mammary, superior and inferior epigastric vessels consequent upon the coarctation. Associated inferior rib notching.

The abdominal aorta is rather diminutive in caliber, presumed consequent upon the coarctation.

The celiac axis is rather generous in caliber.  The common hepatic artery arises solely from the SMA with no hepatic contribution from the celiac. 

The iliac vessels are normal other than being diminutive.

Pronounced hypertrophy of the inferior epigastric arteries.

The lungs are clear.

There is a small low-attenuation lesion peripherally in the right lobe of the liver likely representing an incidental liver cyst. 

Normal arterial phase appearances of the spleen, pancreas, gallbladder, adrenal glands and both kidneys.

Case Discussion

An adult presentation of coarctation of the aorta.   This is a classic case of severe aortic coarctation with extensive compensatory collateralisation.

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Case information

rID: 74632
Published: 9th May 2020
Last edited: 9th May 2020
System: Cardiac
Inclusion in quiz mode: Included

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