Supersized Atheroma Causing Acquired Coarctation of Aorta Leading to Heart Failure

Calcified atheromatous aortic lesion causing significant narrowing of the aorta is an uncommon clinical entity. This calcified atheroma leads to obstruction of the lumen of the aorta simulating acquired coarctation of aorta causing impaired perfusion of lower limbs, visceral ischemia, and hypertensi...

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Bibliographic Details
Published in:JIM - high impact case reports 2017-01, Vol.5 (1), p.2324709616689477-2324709616689477
Main Authors: Karakattu, Sajin, Murtaza, Ghulam, Dinesh, Sharma, Sivagnanam, Kamesh, Schoondyke, Jeffrey, Paul, Timir
Format: Article
Language:English
Subjects:
Calcification
Case Report
Case reports
Coronary vessels
Dyspnea
Heart failure
Hypertension
Ischemia
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Summary:Calcified atheromatous aortic lesion causing significant narrowing of the aorta is an uncommon clinical entity. This calcified atheroma leads to obstruction of the lumen of the aorta simulating acquired coarctation of aorta causing impaired perfusion of lower limbs, visceral ischemia, and hypertension. We report a case of 58-year-old patient who presented with dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, 25-lb weight gain, lower extremity edema, and chest pain. Extensive workup including computed tomography and magnetic resonance imaging revealed a large calcific mass in the aortic arch causing his presenting symptoms. After surgical correction his symptoms resolved. Any patient presenting with heart failure symptoms in the setting of uncontrolled renovascular hypertension, intermittent claudication symptoms, or visceral ischemia with normal ejection fraction but moderate to severe left ventricular hypertrophy should be in high suspicion for acquired coarctation of aorta. The routine thorough examination of pulses in bilateral upper and lower extremities in all hypertensive patients is a very simple and useful clinical tool to diagnose acquired aortic coarctation.
ISSN:2324-7096
2324-7096
DOI:10.1177/2324709616689477