Case presentation
A 23-year-old male patient was admitted to the cardiology outpatient clinic to investigate the aetiology of hypertension. His medical and family history was unremarkable. In the physical examination of the patient, the blood pressure taken from the left arm was 164/96 mmHg, the blood pressure taken from the right arm was 161/92 mmHg, and there was no difference in blood pressure between the lower and upper extremities. Peripheral pulses were bilaterally palpable, radio-femoral, radio-radial delay was not observed. Electrocardiogram was in normal sinus rhythm. Pathological findings in transthoracic echocardiography were bicuspid aortic valve (type 2, NCC+RCC fusion) and in the suprasternal evaluation of descending aorta, peak systolic gradient was measured as 20 mm Hg in doppler evaluation (Figure 1A-B). Buckling of the aorta was seen on the patient’s chest x-ray (Figure 1C). CT angiography was performed for the preliminary diagnosis of aortic coarctation, and it was observed that the distal aortic arch had king formation at the level of the isthmus, and the diameter of the narrowest part was measured as 13*11 mm (Figure 2 -Video 1). In addition, it was obtained that collateral circulation, which is the typical finding of coarctation on CT angiography, did not develop in this patient. A peak 20 mm Hg systolic gradient qas observed between the pre and post psedocoarctation segment in the catheterization study performed on the patient for aortic pressure study. In the light of these clinical and imaging findings, the patient was evaluated as aortic pseudocoarctation.