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Functional aortic coarctation caused by thrombosis within a thoracic aortic aneurysm
C S Lawson1, P J Keeling, L D Smith
1Department of Cardiology, St. Thomas' Hospital, London, UK.
Insights
A leaking thoracic aortic aneurysm caused functional coarctation in a male arteriopath, presenting with chest pain and leg pulse loss. Surgical confirmation validated these findings.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Diagnostic Imaging
Background:
- Arteriopathy can manifest with complex cardiovascular symptoms.
- Thoracic aortic aneurysms require accurate diagnosis and management.
- Functional coarctation is a rare complication of aortic pathology.
Observation:
- A 67-year-old male arteriopath presented with chest pain, a new systolic murmur, and diminished leg pulses.
- Echocardiography and right heart catheterization ruled out mitral regurgitation and ventricular septal defect.
- Computed tomography (CT) scanning revealed a leaking descending thoracic aortic aneurysm.
Findings:
- The aneurysm caused proximal lumen stenosis due to atheroma and thrombus.
- This stenosis resulted in a functional coarctation of the aorta.
- Surgical exploration confirmed the CT findings and the nature of the aortic pathology.
Implications:
- This case highlights the importance of advanced imaging in diagnosing complex aortic pathologies.
- Understanding functional coarctation secondary to aneurysms is crucial for surgical planning.
- Prompt diagnosis and surgical intervention are vital for managing such life-threatening conditions.
Abstract:
A 67 year old male arteriopath presented with chest pain, a new systolic murmur at the lower left sternal border and loss of leg pulses. Mitral regurgitation and ventricular septal defect were excluded by echocardiographic colour flow Doppler mapping and right heart catheterisation. CT scanning demonstrated a leaking aneurysm of the descending thoracic aorta with stenosis of the proximal lumen due to atheroma and thrombus causing a functional coarctation. The findings were confirmed at surgery.