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Pseudocoarctation is an unusual anomaly mirroring true coarctation. Congenital kinking or pseudocoarctation of aorta was never a benign condition. Although surgical repair should be suggested for all symptomatic individuals. Regular follow-up is obligatory for all asymptomatic patients deprived of linked anomalies. We suggest CT-aortogram as a non-invasive imaging modality for the definitive diagnosis of pseudocoarctation.

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Acute Pulmonary Thromboembolism [PE] is associated with high mortality, similar to that of myocardial infarction and stroke. We studied the clinical presentation and management of PE in the Indian population. An analysis of 140 patients who presented with acute PE at a large volume center in India from June 2015 through December 2018 was performed. The mean age of our study population was 50 years with 59% being male. Comorbidities including Deep Vein Thrombosis [DVT], diabetes mellitus, hypertension, and Chronic Obstructive Pulmonary Disease [COPD] were present in 52.9%, 40%, 35.7% and 7.14% of patients, respectively. Out of 140 patients, 40 [28.6%] patients had massive PE, 36 [25.7%] sub-massive PE, and 64 [45.7%] had low risk PE. Overall, in-hospital mortality was 25.7%. Multivariate regression analysis found chronic kidney disease and PE severity to be the only independent risk factors. Thrombolysis was performed in 62.5% of patients with a massive PE and 63.9% of patients with a sub-massive PE. In the massive PE group, patients receiving thrombolytic therapy had lower mortality compared with patients who did not receive therapy[p=0.022], whereas this difference was not observed in patients in the sub-massive PE group. We conclude that patients with acute PE in India presented more than a decade earlier than our western counterparts, and it was associated with poor clinical outcomes. Thrombolysis was associated with significantly reduced in-hospital mortality in patients with massive PE.

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