Severe Aortic Coarctation in an Adult Without Left Ventricular Hypertrophy Nor Overt Collateral Channels

We describe an unusual case of periductal carctation of the aorta in a 40-year-old patient presenting to the echocardiography laboratory for evaluation of a heart murmur. Subsequent clinical history revealed easy fatigability, dyspnea on exertion, and hypertension. Despite a lack of left ventricular hypertrophy, aortic coarctation was suggested by echocardiography. It was later confirmed to be severe by multiple additional imaging modalities, despite an absence of overt collateral arterial channels. The importance of echocardiography in the diagnosis of coarctation of the aorta and the management of this complicated patient is discussed.