Hypertension Secondary to Severe Aortic Coarctation in an Adult Patient

Figures

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  Figure 1. Posteroanterior chest radiograph showing the “figure 3 sign,” characterized by an indentation along the contour of the thoracic aorta due to a focal coarctation with pre and poststenotic dilatation (white arrow). Rib notching is also noted bilaterally (yellow arrows), representing collateral circulation through the intercostal arteries. This finding, known as “Roesler’s sign,” is caused by erosion of the inferior borders of the ribs secondary to increased flow through enlarged collateral vessels.

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  Figure 2. Electrocardiogram showing sinus rhythm at 88 bpm, left axis deviation (–30°), QRS duration of 120 ms, and rS complexes in leads II, III, and aVF.

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  Figure 3. Three-dimensional reconstructions from aortic CTA demonstrating a postductal aortic coarctation with significant dilatation of the aortic segments proximal and distal to the narrowing. CTA: CT angiography

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  Figure 4. (A) Curved planar reformation of aortic CTA showing a severe postductal aortic coarctation with a minimal luminal diameter of 3 mm. (B) Volume-rendered reconstruction demonstrating marked dilation of both internal mammary arteries CTA: CT angiography

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  Figure 5. (A) Pre-intervention thoracic aortogram showing severe aortic coarctation with limited contrast passage across the narrowed segment. The minimum luminal diameter at the coarctation site measured 3.6 mm. (B) Post-intervention aortogram demonstrating successful dilation of the coarcted segment with satisfactory contrast flow; the final luminal diameter reached 16 mm after stent placement.