Unilateral Notching of the Ribs in Cyanotic Heart Disease.

Until 1948 notching of the ribs was considered to be pathognomonic of coarctation of the aorta. Batchelder and Williams (1948), however, drew attention to unilateral notching of the ribs in a patient with tetralogy of Fallot. Unilateral notching is rare, but can occur on the right side when the coarctation is proximal to, or includes, the left subclavian artery (Bayley and Holoubek, 1940; Campbell and Baylis, 1956). It has since been described also in a number of other conditions (Batchelder and Williams, 1948; Holt and Wright, 1948; Reynolds, 1950; Takaro and Clagett, 1951; McCord and Bavendam, 1952; Kent, 1953; Lowe, 1953 and Campbell, 1958), cyanotic heart disease being by far the commonest. This paper reports three further cases.