CTICasesPseudo Coarctation
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Imaging findings
The PA radiograph shows a double density overlying the mediastinum associated with the aorta. The lateral view reveals a mass behind the trachea contiguous with the descending aorta. Cross-sectional imaging confirms a high-riding aortic arch with a kink where it's anchored by the ligamentum arteriosum, but with usually a low gradient (less than 10 mmHg) across the narrowing. A valve prosthesis is present, likely due to an associated bicuspid valve.
Key takeaways
Pseudo coarctation is a classic finding, often associated with bicuspid aortic valves. It involves a kink in the aorta, typically at the site of the ligamentum arteriosum, often due to an embryologic anomaly of the aortic arch. By definition, there is usually little to no gradient across the narrowing, meaning collateral vessels are not seen.
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