title: Aortic coarctation diagnosed in a hypertensive child undergoing Doppler sonography for suspected renal artery stenosis.
abstract: 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.
authors.affiliation: Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210th Street, Bronx, New York 10467, USA. mstein17@aol.com
authors.forename: Marjorie W
authors.initials: MW
authors.lastname: Stein
authors.forename: Mordecai
authors.initials: M
authors.lastname: Koenigsberg
authors.forename: Jerry
authors.initials: J
authors.lastname: Grigoropoulos
authors.forename: Bruce C
authors.initials: BC
authors.lastname: Cohen
authors.forename: Henry
authors.initials: H
authors.lastname: Issenberg
mesh_terms: 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