Incidental Thoracic Aortic Kinking Mimicking Aortic Coarctation: A Case Report

Thoracic aortic kinking, also known as pseudocoarctation of the aorta, is a rare congenital anomaly characterized by elongation and angulation of the aortic arch without significant luminal narrowing. We report the case of a 67-year-old man admitted for hematemesis and melena. CT pulmonary angiography performed during the diagnostic workup revealed a proximal right pulmonary embolism and an incidental marked angulation of the descending thoracic aorta at the level of the aortic isthmus, without evidence of stenosis or collateral circulation. In the absence of clinical and radiological features of true coarctation, the diagnosis of thoracic aortic kinking was established. Conservative management with clinical and radiological follow-up was adopted. This report highlights the importance of recognizing thoracic aortic kinking as a rare benign anomaly that may mimic true aortic coarctation and emphasizes the role of imaging in establishing the correct diagnosis and avoiding unnecessary intervention.