Coarctation of the Aorta
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.
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.
- Copyright © 2001 by American Heart Association