Coarctation of the aorta: additional signs

Area of Science:

• Cardiovascular Imaging
• Thoracic Radiology
• Aortic Diseases

Background:

• Coarctation of the thoracic aorta is a congenital heart defect.
• Classic radiographic signs like rib notching and figure-three configuration are frequently cited but often absent in adult cases.
• Abnormalities of the ascending aorta, aortic arch, and superior mediastinum are significant findings in coarctation.

Purpose of the Study:

• To highlight that classic radiographic signs of adult-type coarctation of the aorta are frequently absent.
• To emphasize the importance of abnormalities in the ascending aorta, aortic arch, and superior mediastinum as key diagnostic indicators.
• To compare radiographic findings of true coarctation with pseudocoarctation.

Main Methods:

• Retrospective review of chest radiographs from 13 patients with adult-type coarctation of the aorta over a 10-year period.
• Comparison of radiographic findings in true coarctation versus five patients with pseudocoarctation.
• Analysis of abnormalities in the ascending aorta, aortic arch, and superior mediastinum.

Main Results:

• The classic signs of coarctation (rib notching, figure-three configuration) were absent in a significant number of adult patients.
• Abnormalities of the ascending aorta, aortic arch, and superior mediastinum were major findings and sometimes the only indicators of coarctation.
• Radiographic findings differed between true coarctation and pseudocoarctation.

Conclusions:

• Radiologists should consider coarctation of the aorta even in the absence of classic signs.
• Abnormalities in the ascending aorta, aortic arch, and superior mediastinum are critical for diagnosing adult coarctation.
• Distinguishing true coarctation from pseudocoarctation relies on a comprehensive assessment of aortic and mediastinal structures on chest radiographs.