Findings:

Rib Notching

Diagnosis : Coarctation of the Aorta

Coarctation of the Aorta

A congenital shelf like defect adjacent to the attatchment of the ductus arteriosis.

The lumen may not be patent, but the walls are in continuity, otherwise it is interuption of the aortic arch.

Pre ductual type is found in infants and associated with Patent Ductus.

Coarct in older patients is often an isolated finding.

Rib notching 3-8 . 1st and 2nd intercostals receive blood from subclavian branches.

Coarctation of the Aorta

Left Ventricle hypertrophy from pressure overload

Symptomatic in infancy Congestive cardiac failure occurs depending on degree of coarctation and closure of ductus arteriosus

Bicuspid aortic valve in 75% Less commonly VSD

Isolated Turner's Syndrome (XO) - 20% females withcoarctation Cerebral "Berry" Aneurysms

Neurofibromatosis I William's Syndrome (Congenital Hypercalcemia)

Sturge-Weber

Post Ductal Pre Ductal

Collateral Flow

IMA, Intercostals, Lateral Thoracic, Aberrant art, Anterior Spinal art

Reverse 3 Sign of Aortic indentation

Pulmonary Arteriogram: Black dot represents inflow from Patent Ductus

Lt Arch with Aberrent Rt Subclavian Art.

Collaterals and rib notching on left side only

Lt Arch with Aberrent Rt Subclavian Art.

Collaterals and rib notching on left side only

The EndThe End