Aortic Coarctation Visualized by 16-Row Detector Multislice Computed Tomography
A 34-year-old man was admitted to the hospital for increased shortness of breath. He was diagnosed as having arterial hypertension at age 14; a screen for secondary arterial hypertension had not been performed. Blood pressure at admission was 180/100 mm Hg on the upper and 120/75 mm Hg on the lower extremities. Auscultation revealed an interscapular systolic murmur. No additional cardiac abnormalities were found. A 16-row detector multislice CT (Figure, left) demonstrated aortic coarctation (unfilled arrow) with classical secondary vascular adaptive features caused by collateral circulation: dilatation of the internal thoracic artery (thin white arrows), the ascending aorta (*) and the intercostal arteries (thick white arrows), which resulted in rib notching (Figure, right, white triangles). Poststenotic tapering of the descending aorta is visible (**). Doppler assessment revealed an intrastenotic peak gradient of 60 mm Hg, which was confirmed invasively. Subsequent surgical correction led to significant improvement of the patient’s clinical condition.