Late diagnosis of coarctation of the aorta in a 44-year-old male: a case report
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CASE REPORT
Late diagnosis of coarctation of the aorta in a 44‑year‑old male: a case report Weijian Luo1, Jilin Li1* , Xiaojun Huang1 and Xiangna Cai2
Abstract Background: Coarctation of the aorta is a rare congenital disease. In adults, the main manifestations include hypertension, weak or absent femoral pulses, heart failure, and left ventricular hypertrophy. Case presentation: We present a case involving a late diagnosis of coarctation of the aorta detected during aortography in a 44-year-old man. The patient underwent stent implantation and aortoplasty. After 2 years of follow-up, the patient was in good condition. Conclusions: This case shows that coarctation of the aorta can be cured and that hypertension caused by the condition can be controlled to some extent with medication. Based on our findings, we recommend a detailed physical examination for all patients suspected of having coarctation of the aorta; the examination should include blood pressure measurements of both the upper and lower extremities. The case of coarctation of the aorta is not common or easy to be found in medium-aged population. Better BP control, earlier repair, and transcatheter intervention may result in a good outcome in that case. Keywords: Case report, Hypertension, Renal inadequacy, Heart failure, Balloon angioplasty, Stent placement, Coarctation of the aorta Background Coarctation of the aorta is a rare congenital heart disease characterized by aortic narrowing. Though it is usually detected during childhood, some patients may remain asymptomatic until adulthood [1–4]. Adults usually present with hypertension, weak or absent femoral pulses, heart failure, and left ventricular hypertrophy. In the hopes of bettering diagnosis and treatment for coarctation of the aorta, we herein present a case involving late diagnosis of the condition.
*Correspondence: [email protected] 1 Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69 Dongxiabei Road, Jinping District, Shantou 515041, Guangdong Province, People’s Republic of China Full list of author information is available at the end of the article
Case presentation A 44-year-old man was hospitalized for 6 days in June, 2012 because of hypertension (> 4 years) (Table 1). During hospitalization, his blood pressure was controlled at around 135/66 mmHg. The cause of hypertension could not be detected despite a thorough laboratory examination and transthoracic echocardiography (TTE). His blood pressure was poorly controlled with benazepril and metoprolol after leaving the hospital. He did not undergo follow-up after discharge. He was hospitalized again for 21 days in February, 2016 due to chest tightness (Table 1). A physical examination showed his blood pressure was 200/105 mmHg. His blood pressure in the lower limbs and femoral pulses were not determined. Results from laboratory tests showed an NT-proBNP level of 24,548 pg/mL and a creatinine level of 152 µmol/L. Echocardiography revealed cardiomegaly, moderate pulmonary hypert
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