A late diagnosis of aortic coarctation began as an acute coronary syndrome

Aortic coarctation accounts the 5%–10% of congenital heart disease. It is usually diagnosed during childhood but the postductal form is most common in adults and may be diagnosed incidentally in the context of investigation for hypertension. The age of correction is the most important factor for the relief of hypertension and long-term survival. We describe a case of a 63-year-old man, came to our emergency room for acute coronary syndrome. Cardiac catheterization with right femoral artery access was performed but for many difficulties during the introduction of catheters was therefore performed aortography that showed an interruption “a cul de sac” at the level of the descending thoracic aorta. With a transradial right approach we opted for the treatment of culprit lesion and later for correction of the aortic coarctation always through a percutaneous approach. Our case report demonstrates that it is possible that aortic coarctation can go unnoticed for many years and can be diagnosed accidentally after the onset of its complications.