Aortic pseudocoarctation is a very rare congenital anomaly of the aortic arch and can coexist with other congenital heart diseases, such as a bicuspid aortic valve.

It mimics true coarctation, but can be differentiated from it by recognizing a high, elongated arch, a kinking that lacks luminal narrowing and an absence of enlarged collateral arteries.

The identification of aortic pseudocoarctation can be an incidental finding, as in this case, or associated with hypertension and symptoms related to compression of adjacent structures.

Its management is not well established, although if asymptomatic no action is required, however surgical treatment has been proposed in symptomatic patients or when associated with aortic aneurysms.

Case courtesy of Dr Mohsen Alkmeshi, Nottingham University Hospitals, UK.