Highly Effective Compensatory Mechanisms in a 76-Year-Old Man with a Coarctation of the Aorta

Miró, Òscar; Jiménez, Sònia; González, Juan Fernández; Caralt, Teresa M. de; Ordi, Jaume

doi:10.1159/000006989

Cited by 13 publications

(13 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Death in these patients is usually due to heart failure, coronary artery disease, aortic rupture/dissection, concomitant aortic valve disease, infective endarteritis/endocarditis, or cerebral hemorrhage4,5. There are few reports of patients first diagnosed with uncorrected aortic coarctation at very late age2,6,7, Treatment consists of aggressive hypertension therapy, endocarditis prophylaxis and corrective treatment for coarctation lesions with a high gradient8. In this case report, we present aortic coarctation with bicuspid aortic valve in a 52-year-old male.…”

Section: Discussionmentioning

confidence: 99%

A severe coarctation of aorta in a 52-year-old male: a case report

Çiçek

Haberal²,

Özkan³

et al. 2010

Int. J. Med. Sci.

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

A severe coarctation of aorta in a 52-year-old male: a case report

Çiçek

Haberal²,

Özkan³

et al. 2010

Int. J. Med. Sci.

View full text Add to dashboard Cite

show abstract

“…Death in these patients is usually due to heart failure, coronary artery disease, aortic rupture/dissection, concomitant aortic valve disease, infective endarteritis/endocarditis, or cerebral hemorrhage [3,7]. There are few reports of patients first diagnosed with uncorrected aortic coarctation at very late age [4][5][6], and there is no consensus on how to manage them. In this report, we present the case of a 72-year-old woman first diagnosed with severe aortic coarctation.…”

Section: Discussionmentioning

confidence: 99%

A severe coarctation of aorta in a 72-year-old female: a case report

et al. 2009

View full text Add to dashboard Cite

Aortic coarctation is a congenital malformation of the aorta usually diagnosed and corrected early in life. Long-term survival is exceptional in patients with untreated aortic coarctation. In this case report, we present a late diagnosis of aortic coarctation in a 72-year-old female. Our patient was relatively asymptomatic until she presented with exertional dyspnea and fatigue in her seventh decade of life. The patient was managed conservatively with aggressive antihypertensive medication. After the 1-year follow-up visit, the patient was in good clinical condition, without, however, adequate control of blood pressure. Case presentationA 72-year-old obese Caucasian woman was referred to our hospital because of increasing fatigue and exertional dyspnea. She had been well until 10 months previously. The patient had a medical history of diabetes, dyslipidemia and hypertension. Her hypertension was poorly controlled despite a combination of antihypertensive agents (b-blocker, diuretic, calcium channel blocker and angiotensin receptor blocker).Physical examination showed blood pressure 125/75 in both arms and a heart rate of 77 beats/minute. A systolic ejection murmur was heard at the left upper sternal border. Femoral pulses were palpable bilaterally but weak and delayed compared to the brachial pulses. Electrocardiography revealed sinus rhythm and left bundle branch block. A cardiac silhouette at the upper limits of normal and notching of the ribs were observed on the chest radiography. Her echocardiogram showed dilatation of ascending aorta (42 mm), tricuspid sclerotic aortic valve with mild stenosis, moderate systolic dysfunction of the left ventricle (ejection fraction 45-50%) and a turbulent jet at the distal aortic arch. Although it is extremely rare at this age, aortic coarctation was suspected and thoracic computed tomography (CT) angiography was performed. The CT angiogram disclosed severe coarctation of aorta distal to the origin of the left subclavian artery (Figure 1) with post-stenotic dilatation. Compensatory dilatation of the intercostals arteries was noted.The patient underwent cardiac catheterization to evaluate her coronary artery disease and the severity of the coarctation. Coronary angiography performed using a 5Fr pigtail catheter via right radial artery showed coronary arteries of normal distribution without significant atheromatosis. Aortography revealed a significant, tortuous,

show abstract

“…In the elderly, few cases have been reported of partial pulmonary venous drainage 14,15 concerning left pulmonary connection or anomalous connection with the inferior vena cava. Only 12 patients with untreated aortic coarctation have been previously reported to be alive Ͼ70, 16 and only few patients with corrected trans- 22 and ventricular septal defect. 23 Normally, these severe and complex CHDs have a high mortality in childhood, and their late diagnosis in adulthood or old age depend on the balance and compensation between the associated cardiac defects.…”

Section: Discussionmentioning

confidence: 99%