Cardiology Series: Case 13



ANSWERS WILL BE POSTED TOMORROW 17/2/17 BY 17:00

A 19-year old female presents with difficulty breathing on mild exertion and increased fatigue.

Upon examination, the following were found:

  • Blood Pressure 175/110
  • Weak Femoral Pulse
  • Femoral pulse come later than the radial (Radiofemoral Delay)

Image result for aortic coarctation

1. Which diagnosis are you suspecting this patient might have ?

2. Is this condition more prevalent in males or females ? 

3. Which syndrome is associated with this condition in females ? 

4. Which investigations would you request ?

5. How would you manage this patient ?

6. Which complications may arise if left untreated ?

Source:http://www.slideshare.net/hridayroy/coarctation-of-aorta-a-case-report


ANSWERS

1. Coarctation of the aorta

2. Males

3. Turner’s syndrome

4. Investigations

Coarctation of the aorta can be accurately diagnosed with magnetic resonance angiography.

The severity of coarctation of the aorta can be rated by a combination of the smallest aortic cross-sectional area of the aorta (adjusted for body surface area) as measured by 3D-rendered contrast MRI, as well as mean heart rate–corrected flow deceleration in the descending aorta as measured by phase contrast magnetic resonance imaging.

5. Management

Treatment is usually conservative if asymptomatic. If the incidence of arterial hypertension, surgical resection of the narrow segment is required. In some cases, angioplasty is required to dilate the narrow segment.

Image result for treatment of aortic coarctation

Source: http://www.slideshare.net/gchoyer/cardiovascular-disorders-12641878

6. Complications

  • High blood pressure
  • Stroke
  • Enlargement in a section of the wall of the aorta (aneurysm)
  • Aortic rupture or tear (dissection)
  • Premature coronary artery disease — narrowing of the blood vessels that supply the heart
  • Heart failure
  • A weakened or bulging artery in the brain (brain aneurysm) or bleeding in the brain (hemorrhage)

 

 

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