E-page Original Image: A rare angiographic finding: aortic pseudo-coarctation

Aortic pseudo-coarctation is a quite rare cardiovascular malformation characterized by a redundant and severely kinked aortic arch. Diagnostic assessment is usually performed by angiography or other imaging techniques. In this report, we present a 49-year-old man who was admitted to our department because of chest pain. On physical examination he had rhythmic heart beats, 3/6 systolic murmur on the second left intercostal space. The electrocardiography revealed sinus rhythm with a ventricular rate of 75 beats/min and normal electrocardiographic findings. Echocardiogram demonstrated normal left ventricular function and wall motion. There was no pathology at valves. Transthoracic echocardiographic examination through suprasternal window showed maximal 15 mmHg gradient. At a first glance in aortography, severe aortic coarctation was considered (Video 1. See corresponding video/movie images at www.anakarder.com). However, aortic gradient was found to be of 15-20 mmHg by pigtail catheter. In addition, there was no a typical coarctation pattern in different positions.