CTICasesUnrepaired Aortic Coarctation with Rheumatic Mitral Stenosis
Imaging findings
Chest radiograph shows cardiomegaly, rib notching of the posterior ribs, and a figure-3 sign. CT angiography shows severe narrowing of the aortic arch (coarctation) with large intercostal collateral arteries, along with severe left atrial enlargement and mitral valve calcification consistent with rheumatic mitral stenosis.
Key takeaways
Unrepaired aortic coarctation can present in adulthood with hypertension and heart failure, characterized by collateral intercostal artery enlargement causing rib notching. The coexistence of rheumatic mitral stenosis leads to severe left atrial enlargement and pulmonary venous congestion, complicating hemodynamic management.
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