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 type 1 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

Cases of Coarctation of Aorta