Coarctation of the aorta: a misdiagnosed cause of hypertension

Clinically, patients may remain asymptomatic for years, although up to half may present lack of lower limbs pulse, typical systolic-diastolic murmur and an increased pressure gradient by echocardiography, which is required for the diagnosis. This method allows measuring the aortic gradient, but eventually a computed tomography angiography (CTA) of the aorta may be also necessary. Treatment involves clinical management of hypertension and heart failure symptoms, followed by surgical or balloon angioplasty for the correction of the narrowed segment. Though the surgical correction is often successful, life-long clinical and echocardiographic follow-up is required as re-coarctation occurs in one-third of patients.