Aortic coarctation diagnosed in a hypertensive child undergoing Doppler sonography for suspected renal artery stenosis.
A 5-year-old girl presented with hypertension, with no perceived blood pressure differential between the lower and upper extremities. Doppler ultrasound revealed a tardus-parvus pattern with diminished systolic acceleration and peak systolic velocities in the abdominal aorta and both main renal arteries. Doppler interrogation of the suprasternal aorta showed a normal waveform, suggesting a partial obstruction distally. Echocardiography and aortography confirmed severe discrete aortic coarctation with transverse arch hypoplasia. Because classic findings of aortic coarctation may not be present, especially in the older child, the radiologist must be aware that a tardus-parvus Doppler waveform in the abdominal aorta and bilateral renal arteries is suggestive of proximal aortic stenosis, which may be localized by spectral Doppler of the aortic arch.
Stein
Marjorie W
MW
Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210th Street, Bronx, New York 10467, USA. mstein17@aol.com
Koenigsberg
Mordecai
M
Grigoropoulos
Jerry
J
Cohen
Bruce C
BC
Issenberg
Henry
H
D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology; D001017:Aortic Coarctation / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000473:pathology; D012078:Renal Artery Obstruction / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D018608:Ultrasonography, Doppler