Findings: Rib Notching

2. Diagnosis : Coarctation of the Aorta Findings: Rib Notching

3. Coarctation of the Aorta A congenital shelf like defect adjacent to the attatchment of the ductus arteriosis. The lumen may not be patent, but the walls are in continuity, otherwise it is interuption of the aortic arch. Pre ductual type is found in infants and associated with Patent Ductus. Coarct in older patients is often an isolated finding. Rib notching 3-8 . 1st and 2nd intercostals receive blood from subclavian branches.

4. Coarctation of the Aorta Left Ventricle hypertrophy from pressure overload Symptomatic in infancy Congestive cardiac failure occurs depending on degree of coarctation and closure of ductus arteriosus Bicuspid aortic valve in 75% Less commonly VSD Isolated Turner's Syndrome (XO) - 20% females with coarctation Cerebral "Berry" Aneurysms Neurofibromatosis I William's Syndrome (Congenital Hypercalcemia) Sturge-Weber

5. Post Ductal Pre Ductal

9. Collateral Flow IMA, Intercostals, Lateral Thoracic, Aberrant art, Anterior Spinal art

12. Reverse 3 Sign of Aortic indentation

13. Pulmonary Arteriogram: Black dot represents inflow from Patent Ductus

14. Lt Arch with Aberrent Rt Subclavian Art. Collaterals and rib notching on left side only

15. Lt Arch with Aberrent Rt Subclavian Art. Collaterals and rib notching on left side only

16. The End