Coarctation of Aorta

  • Infantile / diffuse = preductal from innominate to ductus
    Etiology: congenital
    Imaging: long segment narrowing
    Clinical: ductal dependent for collateral flow
  • Adult / focal = ductal / postductal
    Etiology: acquired, due to rubella or neurofibromatosis in adults
    CXR: 3 sign is prestenotic dilation ascending aorta / coarctation / post-stenotic dilation descenging aorta, rib notching takes 10 years due to shunting from subclavian artery -> internal thoracic artery -> intercostal arteries -> descending aorta, first 2 ribs spared because they are supplied from costocervical trunk
    UGI: Reverse 3 sign is hypolastic aortic knob with dilated post stenotic segment
    Clinical: most common form, presents later due to presence of collaterals

Radiology Cases of Coarctation of Aorta

CXR of coarctation of aorta
CXR AP shows a 3 sign in the region of the aortic arch and bilateral rib notching.