Presentation
Hypertension, easy fatigability.
Patient Data
Frontal chest radiograph shows bilateral inferior notching of the posterior ribs. Focal indentation of the lateral border of the proximal descending thoracic aorta (figure 3 sign) is also noted.
There is a focal marked narrowing of the aortic lumen just distal to the origin of the left subclavian artery. Bilateral internal thoracic arteries are dilated and tortuous, better demonstrated on the coronal MIP image. There are also multiple, dilated, tortuous intercostal and paravertebral arterial collaterals.
Case Discussion
The radiographic and CT features are characteristic of coarctation of aorta. Echocardiography done to look for associated cardiac anomalies (not shown) showed left ventricular hypertrophy and a normal tricuspid aortic valve.