CTICasesIncidental Pseudocoarctation with a High, Kinked Aortic Arch
Imaging findings
An older patient's chest radiograph obtained for an unrelated reason shows a high aortic arch with a subtle kink and no rib notching. CT confirms a high-riding arch with a focal kink at the expected ligamentum arteriosum attachment point but no significant luminal narrowing or measurable pressure gradient; the aortic valve is normal, unlike prior pseudocoarctation cases with bicuspid valves.
Key takeaways
A high aortic arch with a focal kink at the ligamentum attachment site, without a significant pressure gradient (by definition less than about 10 mmHg) or rib notching, represents an incidental pseudocoarctation; unlike some pseudocoarctation cases, this one occurred with a structurally normal aortic valve.
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