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Coarctation of the Aorta

Marquardt JPM - MedPix (2010)

View Article: MedPix Image - MedPix Case

Affiliation: Naval Medical Center San Diego

ABSTRACT

Diagnosis: Coarctation of the Aorta

History: 11 y.o. girl with systemic hypertension and a murmur.

Findings: The thoracic aorta is notable for high-grade coarctation with post-stenotic dilatation. The level of the stenosis is 2.5 cm distal to the take off of an otherwise enlarged left subclavian artery. Multiple enlarged collateral vessels are identified, including bilateral internal mammary, intercostal, and subphrenic arteries. The branch vessels are all patent.

Ddx: •Aortic dissection •Coarctation of the aorta •Focal vasculitis •Extrinsic mass pressing on the aorta

Dxhow: Cardiac gated CT with angiography of the heart and aorta

Exam: • Blood pressure in right arm 140/90 and in right leg 118/66. • HEENT: Normocephalic, atraumatic, no scleral icterus • Cardiovascular: Regular rate and rhythm with normal S1 and S2 physiologic splitting, no S3 or S4. Murmur auscultated at anterior chest which is moderately harsh, low-pitched, grade 2/6 systolic ejection murmur that is best heard at the left upper sternal boarder. From the posterior, the murmur is more distinct and clear at the left parasternal area. • Lungs: Clear to auscultation bilaterally with no wheezes, rhonchi, rales • Abdomen: Soft, nontender, nondistended, normal auscultation • Extremities: No clubbing or edema noted PMH: Nephrology evaluation heard a systolic murmur. No murmur had ever been mentioned to the patient’s mother in the past. She never had any cardiovascular symptoms during feeding as an infant; such as sweating, dyspnea, irritability, cyanosis, frequent pauses, etc. Her growth and development have been normal. She is active without cardiovascular symptoms during exercise. • Echocadiogram showed possible coarctation of the aorta and a cardiac gated CT was ordered for better demonstration of the anomaly.

No MeSH data available.


Axial CT angiogram, at the tracheal bifurcation, demonstrates focal stenosis of the aorta at the level of the coarctation.
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MPX1321_synpic54278: Axial CT angiogram, at the tracheal bifurcation, demonstrates focal stenosis of the aorta at the level of the coarctation.


Coarctation of the Aorta

Marquardt JPM - MedPix (2010)

Axial CT angiogram, at the tracheal bifurcation, demonstrates focal stenosis of the aorta at the level of the coarctation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1321&req=5

MPX1321_synpic54278: Axial CT angiogram, at the tracheal bifurcation, demonstrates focal stenosis of the aorta at the level of the coarctation.

View Article: MedPix Image - MedPix Case

Affiliation: Naval Medical Center San Diego

ABSTRACT

Diagnosis: Coarctation of the Aorta

History: 11 y.o. girl with systemic hypertension and a murmur.

Findings: The thoracic aorta is notable for high-grade coarctation with post-stenotic dilatation. The level of the stenosis is 2.5 cm distal to the take off of an otherwise enlarged left subclavian artery. Multiple enlarged collateral vessels are identified, including bilateral internal mammary, intercostal, and subphrenic arteries. The branch vessels are all patent.

Ddx: •Aortic dissection •Coarctation of the aorta •Focal vasculitis •Extrinsic mass pressing on the aorta

Dxhow: Cardiac gated CT with angiography of the heart and aorta

Exam: • Blood pressure in right arm 140/90 and in right leg 118/66. • HEENT: Normocephalic, atraumatic, no scleral icterus • Cardiovascular: Regular rate and rhythm with normal S1 and S2 physiologic splitting, no S3 or S4. Murmur auscultated at anterior chest which is moderately harsh, low-pitched, grade 2/6 systolic ejection murmur that is best heard at the left upper sternal boarder. From the posterior, the murmur is more distinct and clear at the left parasternal area. • Lungs: Clear to auscultation bilaterally with no wheezes, rhonchi, rales • Abdomen: Soft, nontender, nondistended, normal auscultation • Extremities: No clubbing or edema noted PMH: Nephrology evaluation heard a systolic murmur. No murmur had ever been mentioned to the patient’s mother in the past. She never had any cardiovascular symptoms during feeding as an infant; such as sweating, dyspnea, irritability, cyanosis, frequent pauses, etc. Her growth and development have been normal. She is active without cardiovascular symptoms during exercise. • Echocadiogram showed possible coarctation of the aorta and a cardiac gated CT was ordered for better demonstration of the anomaly.

No MeSH data available.