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Left subclavian artery aneurysm presenting as pseudocoarctation on CT angiogram
J Ezhilan1, Thomas George, Payal Khatri
1Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Mogappair, Chennai, India. icvddoctors@mmm.org.in
Indian Heart Journal
|February 27, 2009
Summary
A hypertensive patient had a left subclavian artery aneurysm and aortic pseudo-coarctation. Cardiac catheterization revealed no pressure gradient across the pseudo-coarctation segment, indicating its non-obstructive nature.
Area of Science:
- Cardiovascular medicine
- Vascular surgery
- Diagnostic imaging
Background:
- Aneurysms of the subclavian artery are rare but serious vascular conditions.
- Hypertension is a significant risk factor for aneurysm development and progression.
- Pseudo-coarctation of the aorta is a congenital anomaly that can mimic true coarctation.
Observation:
- A 36-year-old male presented with a diagnosed aneurysm of the left subclavian artery.
- Computed tomography (CT) imaging suggested the presence of a left subclavian aneurysm.
- The CT scan also indicated findings suggestive of pseudo-coarctation of the aorta.
Findings:
- Cardiac catheterization was performed to assess the aortic pseudo-coarctation.
- Hemodynamic assessment revealed no significant pressure gradient across the pseudo-coarctation segment.
- This finding suggests that the pseudo-coarctation was functionally non-obstructive in this patient.
Implications:
- The absence of a gradient across the pseudo-coarctation is crucial for clinical management decisions.
- Further investigation may be warranted to understand the natural history of non-obstructive pseudo-coarctation in the presence of subclavian aneurysms.
- This case highlights the importance of integrated diagnostic approaches, combining imaging and hemodynamic studies, in managing complex vascular pathologies.
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