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(Circulation. 2001;103:e27.)
© 2001 American Heart Association, Inc.

Images in Cardiovascular Medicine

Coarctation of the Aorta

M. Brueck, MD; R. Janka, MD; W. G. Daniel, MD

From the Division of Cardiology and the Institute of Radiology, University Hospital, Erlangen-Nuremberg, Germany.

Correspondence to Martin Brueck, MD, Division of Cardiology, University Hospital, Oestliche Stadtmauerstraße 29, D-91054 Erlangen-Nuremberg, Germany.

A 51-year-old man was admitted to the hospital for cardiac catheterization because of a small ventricular septal defect documented by echocardiography. Dyspnea on exertion was the leading symptom. Physical examination revealed only weak and delayed femoral pulses, whereas blood pressure measured 185/80 mm Hg in both arms. A grade 3/VI midsystolic murmur was heard predominantly in the left midthoracic region close to the spine. The chest roentgenogram revealed rib notching by increased collateral circulation. Thoracic MRI demonstrated an extreme coarctation (Figure, black arrow) located near the junction of the aortic arch and the descending aorta. In addition, large collaterals were present (white arrows). At catheterization, there was a mean pressure gradient of 70 mm Hg across the coarctation.

View larger version (131K): [in this window] [in a new window]   Figure 1. Coarctation of the aorta. AA indicates ascending aorta; DA, descending aorta; ITA, internal thoracic arteries; LA, left atrium; and LV, left ventricle.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Brueck, M. Articles by Daniel, W. G. Search for Related Content PubMed PubMed Citation Articles by Brueck, M. Articles by Daniel, W. G. Related Collections Other heart failure Other hypertension CT and MRI