title: Supersized Atheroma Causing Acquired Coarctation of Aorta Leading to Heart Failure.
abstract: Calcified atheromatous aortic lesion causing significant narrowing of the aorta is an uncommon clinical entity. This calcified atheroma leads to obstruction of the lumen of the aorta simulating acquired coarctation of aorta causing impaired perfusion of lower limbs, visceral ischemia, and hypertension. We report a case of 58-year-old patient who presented with dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, 25-lb weight gain, lower extremity edema, and chest pain. Extensive workup including computed tomography and magnetic resonance imaging revealed a large calcific mass in the aortic arch causing his presenting symptoms. After surgical correction his symptoms resolved. Any patient presenting with heart failure symptoms in the setting of uncontrolled renovascular hypertension, intermittent claudication symptoms, or visceral ischemia with normal ejection fraction but moderate to severe left ventricular hypertrophy should be in high suspicion for acquired coarctation of aorta. The routine thorough examination of pulses in bilateral upper and lower extremities in all hypertensive patients is a very simple and useful clinical tool to diagnose acquired aortic coarctation.
authors.affiliation: East Tennessee State University, Johnson City, TN, USA.
authors.forename: Sajin
authors.initials: S
authors.lastname: Karakattu
authors.affiliation: East Tennessee State University, Johnson City, TN, USA.
authors.forename: Ghulam
authors.initials: G
authors.lastname: Murtaza
authors.affiliation: East Tennessee State University, Johnson City, TN, USA.
authors.forename: Sharma
authors.initials: S
authors.lastname: Dinesh
authors.affiliation: East Tennessee State University, Johnson City, TN, USA.
authors.forename: Kamesh
authors.initials: K
authors.lastname: Sivagnanam
authors.affiliation: East Tennessee State University, Johnson City, TN, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Schoondyke
authors.affiliation: East Tennessee State University, Johnson City, TN, USA.
authors.forename: Timir
authors.initials: T
authors.lastname: Paul
keywords: atheromatous lesion; calcification; coarctation of aorta