Delayed presentation of aortic coarctation as an aortic dissection: a case report

Coarctation of the aorta is a congenital heart defect characterized by a localized narrowing, typically situated just distal to the left subclavian artery. While it is often diagnosed and treated early in life, some cases may remain asymptomatic until adulthood, potentially leading to severe complications such as hypertension, stroke, heart failure, and, in rare instances, aortic dissection.

We present the case of a 30-year-old female who experienced progressive chest pain accompanied by refractory hypertension. Upon conducting a CT angiography, we discovered aortic coarctation, which was further complicated by aortic dissection extending into the abdominal aorta, along with thrombosis in the false lumen.

This case underscores the risks associated with late-diagnosed aortic coarctation, including dissection and thrombosis. It highlights the critical importance of maintaining a high index of suspicion for refractory hypertension and emphasizes the need for vigilant monitoring and timely intervention in patients with coarctation or hypertension presenting with atypical symptoms.