“ Narrowing of the aortic isthmus, mostly occurs in males (80%). Associated with multiple congenital anomalies, most commonly a bicuspid ao...
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Narrowing of the aortic isthmus, mostly occurs in males (80%).
Associated with multiple congenital anomalies, most commonly a bicuspid aortic valve (seen in 80%).
Other associations include Turner syndrome (15%-20%), posterior fossa malformations-hemangiomas-arterial anomalies-cardiac defects-eye (PHACE) syndrome and intracerebral berry aneurysms and bleeds.
Causes heart failure in infancy and hypertension later.
PLAIN
• Cardiomegaly with left ventricular hypertrophy.
• Look for the ‘reverse 3 sign,’ formed by pre-stenotic aortic dilatation, the coarctation and poststenotic dilatation.
• Inferior rib notching (large collateral intercostal vessels), most commonly affecting the fourth to eighth posterior ribs after 5 years of age.
Coarctation of the aorta. Chest x-ray demonstrating cardiomegaly, a reverse 3 sign (red arrow) and inferior rib notching (white arrow).
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