CTICasesAortic Coarctation
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Imaging findings
A chest radiograph reveals an abnormal contour of the aortic arch, presenting as the classic '3 sign', with a second density adjacent to the arch. Subtle rib notching is also visible. A CTA beautifully demonstrates the severe aortic coarctation, along with extensive collateral vessels in the central mediastinum that bypass the narrowed segment of the aorta. This patient did not have a bicuspid aortic valve.
Key takeaways
Aortic coarctation is a congenital narrowing of the aorta that, when significant, leads to characteristic radiographic findings such as the '3 sign' on frontal chest X-rays and rib notching due to enlarged collateral intercostal arteries. CTA provides detailed anatomical evaluation of the coarctation and the compensatory collateral circulation. The severity of the gradient dictates clinical presentation, with less severe cases sometimes presenting in advanced adulthood.
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