Description
We report the case of a man aged 55 years who was referred to our department for investigation of arterial hypertension. He had only a previous diagnosis of situs inversus. At presentation, his blood pressure was 190/100 mm Hg in both arms, but significantly lower in lower limbs. The pulses were equal over both upper extremities, but lower limbs pulses were also weakly palpable. On cardiac auscultation, a grade II/VI systolic murmur was heard on the right scapular region.
Chest radiography showed dextrocardia and bilateral rib notching (figure 1).
Figure 1
Chest radiogram showing bilateral rib notching (arrow).
The transthoracic echocardiography showed mild concentric hypertrophy and mild dilation of the ascending thoracic aorta; due to a poor suprasternal view, the aortic arch could not be adequately assessed.
Multislice CT angiography revealed a complete interruption of the aortic arch distal to the origin of...
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