Description
A 52-year-old Caucasian woman with a history of hypertension since age 30 was referred to cardiology department due to aortic stenosis. She had exertional dyspnoea, without thoracic pain or syncope. There was no blood pressure gradient between upper and lower extremities. Transthoracic echocardiography revealed bicuspid aortic valve, severe valvular aortic stenosis and dilation of ascending aorta (figure 1). There was also a tapering of the descending aorta, with turbulent flow and a systolic peak gradient of 19 mm Hg (figure 2). To assess the thoracic aorta, the patient underwent CT angiography, which revealed elongation of the distal aortic arch, a focal kinking at the aortic isthmus, and absence of significant stenosis and enlarged collateral arteries, consistent with aortic pseudocoarctation (figure 3).
Figure 1
Transthoracic echocardiography. (A) Bicuspid aortic valve with fusion of the right and left cusps and superimposed calcific changes....
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