Coarctation of the aorta in a 6 month old

A 6-month-old male presented with increased respiratory efforts, a low grade fever, O2 saturations in the high 80s and wheezing. Symptoms improved with nebulized albuterol. A chest X-ray revealed cardiomegaly and a rightsided infiltrate (Figs. 1 and 2); EKG revealed criteria consistent with left ventricular hypertrophy (LVH). An echocardiogram confirmed coarctation of the aorta (Fig. 3). Coarctation of the aorta is a narrowing of the lumen of the aortic arch classified as either “pre-ductal” or “post-ductal” based on the location relative to the origin of the left subclavian artery [1–3]. In 85% of cases, coarctation of the aorta is seen with other congenital defects [1]. Males are twice as likely to have coarctation of the aorta, although it is a common manifestation of Turner’s syndrome [1, 3].