Aortic Coarctation Assessed With a Multimodality Approach

Traumatic aortic injury is the second most common cause of death after blunt trauma in motor vehicle accidents. Aortic coarctation leading to resistant hypertension is a rare late complication of aortic repair.

We present a case of a 50-year-old male with previous history of aortic repair presenting with resistant hypertension. Multimodal imaging with computed tomography angiography and cardiac magnetic resonance imaging revealed focal narrowing of the proximal descending thoracic aorta requiring surgical repair.

This case highlights the importance of a multimodal diagnostic approach to diagnose clinically significant aortic coarctation and underscores the need for vigilance for secondary causes of resistant hypertension.

In the workup of resistant hypertension in patients with prior aortic surgery, the use of multimodal imaging to assess stenosis, graft status, and collaterals is essential. Anatomical intervention leads to improved blood pressure control; however, postrepair surveillance for hypertension and vascular is critical.