Coarctation of aorta is a congenital vascular malformation which occurs as a discrete stenosis or as a long, hypoplastic aortic segment. It accounts for 5-8% of all congenital heart defects. In most cases it is diagnosed during infancy and childhood, while adult cases with aortic coarctation are rare. Clinical findings depend on the severity of the vascular lesion. Hypertension can be the only manifestation present and it may not become evident until adulthood.In this case report, we present the diagnosis of aortic coarctation in a 21-year-old female patient detected during the evaluation of hypertension. Transthoracic echocardiography findings revealed a coarctation of descendent aorta with dimension of 5mm and a mean systolic gradient of 60mmHg, which was confirmed by CT angiography of aorta. It was managed by percutaneous balloon angioplasty with stent placement.Although rare in adults, coarctation of aorta should be considered in differential diagnosis of secondary hypertension. Delayed diagnosis and management of aortic coarctation is associated with increased risk of serious cardiovascular complications and a high mortality rate.
Introduction: Left atrial thrombi are present in one third of patients with severe rheumatic mitral stenosis and atrial fibrillation. A left atrial mass can be diagnosed as a thrombus by transthoracic echocardiography in the presence of the predisposing factors for a thrombus such as mitral stenosis and atrial fibrillation. The sensitivity of transthoracic echocardiography for detecting left atrial appendage thrombi is low, and only a few case reports have been described in the literature. Case Presentation: This report describes the case of a 65-year-old female with severe rheumatic mitral stenosis and chronic atrial fibrillation presenting with congestive heart failure. This patient was shown, by means of transthoracic echocardiography, to have a large immobile left atrium cavity mass (6.5 × 3.4 × 2.3 cm) and a large left atrial appendage mass (1.7 cm) identified as a thrombus. Contrast computed tomography of the chest confirmed the diagnosis. Conclusions: Transthoracic echocardiography was sufficient to establish the diagnosis and to decide its management.Keywords:Atrial Function; Left Atrial Appendage; Thrombosis; Echocardiography Implication for health policy/practice/research/medical education: Better understanding of the use of transthoracic echocardiography in the differential diagnosis of cardiac masses.
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