A late diagnosis and treatment of coarctation of aorta six months after presenting with aortic dissection

Abstract

Coarctation of the aorta (CoA) is a congenital condition causing narrowing of the aorta, typically just after the left subclavian artery. Most patients with CoA are diagnosed at birth or during infancy. However, they can also be undiagnosed later in adulthood with minimal symptoms to show or treatment-resistant hypertension.  However, some patients may also present with life-threatening medical emergencies that may lead to an undiagnosed CoA. This case is a 40-year-old man with hypertension who presented with a late diagnosis of CoA on computed tomography imaging six months after ascending aorta dissection repair. The patient's CoA was repaired via an endovascular approach with stent placement and post-dilatory balloon angioplasty. His CoA segmental blood pressure gradient was 25 mmHg and decreased to 3 mmHg post-procedure. The patient has done well post-procedure, and his blood pressure had been within normal limits.

Key words: Aortic coarctation, aortic dissection, hypertension, congenital heart defect