Coarctation of the Aorta
A 6-year-old boy was found incidentally to have a blood pressure of 160/120 mm Hg. Renal ultrasound scanning with Doppler demonstrated a delayed and flattened (ie, tardus-parvus) arterial waveform in the renal artery and distal aorta (Figure 1A; available at www.jpeds.com). With 4 extremity blood pressure measurements, a 30 mm Hg differential between upper and lower extremities was shown. With a chest radiograph, a rib notching was shown (Figure 2; available at www.jpeds.com). With cardiac magnetic resonance imaging, a severe aortic coarctation was revealed (Figure 3).
Figure 1.
Renal ultrasound scanning. A, Renal ultrasound scan with Doppler demonstrating a tardus-parvus waveform in a 6-year-old boy. B, Renal ultrasound scan in a healthy age-matched control subject.
Figure 2.
Chest radiograph reveals bilateral rib notching (examples noted by white arrows).
Figure 3.
Three-dimensional reconstruction of gadolinium-enhanced magnetic resonance angiogram demonstrating severe coarctation of the aortic isthmus, approximately 2 to 3 mm in diameter. Note the extensive collateral vessels to the descending aorta.
PII: S0022-3476(08)00063-2
doi:10.1016/j.jpeds.2008.01.022
© 2008 Mosby, Inc. All rights reserved.
