The value of chest x-ray in the diagnosis of aortic coarctation
https://doi.org/10.38109/2225-1685-2025-1-58-62
Abstract
Aortic coarctation is a form of generalized arteriopathy and is not limited to narrowing of the aorta. It can develop as a local stenosis, or as an extended one, in the form of hypoplasia of the aortic segment [1].
The symptoms and signs depend on the severity of the aortic coarctation. Patients with aortic coarctation who have reached adolescence live to an older age. In the second half of their life, they may develop complications associated with long-term hypertension [2].
Often, the identification of this rare adult malformation is associated with certain difficulties or is an accidental finding in a patient with arterial hypertension. According to modern clinical recommendations [1, 2, 4], the methods of diagnosis of aortic coarctation are physical examination (in particular, determination of the gradient of blood pressure on the arms and legs [5]), ECHO-KG, CT and MRI.
CT and MRI are methods of clarifying diagnostics that allow to verify the defect and determine its morphological features. However, classical radiography in older patients with isolated aortic coarctation in the vast majority of cases has such characteristic signs that it allows you to suspect a defect from an overview image in a direct projection.
The purpose of this report is to draw attention to the possibilities of classical X–ray examination in detecting aortic coarctation in adults. Classical X-ray examination is still the leader in the structure of radiation studies in the Russian Federation, it is performed frequently, therefore, knowledge of the X-ray semiotics of this rare congenital defect will contribute to its earlier detection.
About the Authors
I. Z. KorobkovaRussian Federation
Irina Z. Korobkova, Cand. Of Sci (Med.), Head of the X-ray room of the Department of Radiation Diagnostics; Associate Professor, Department of Radiology and Radiology
15 a Academician Chazov street, Moscow 121552
2/1 Barrikadnaya St., 123995
N. V. Buldakova
Russian Federation
Nina V. Buldakova, clinical resident, Department of Tomography
15 a Academician Chazov street, Moscow 121552
A. Yu. Matchina
Russian Federation
Alexandra Yu. Matchina, clinical resident, Department of Tomography
15 a Academician Chazov street, Moscow 121552
O. V. Stukalova
Russian Federation
Olga V. Stukalova, Cand. Of Sci (Med.), Senior Researcher, Department of Tomography
15 a Academician Chazov street, Moscow 121552
S. A. Gaman
Russian Federation
Svetlana A. Gaman, Cand. Of Sci (Med.), Senior Researcher, Department of Tomography
15 a Academician Chazov street, Moscow 121552
References
1. Baumgartner H, De Backer J, Babu-Narayan SV, et al., от имени рабочейгруппы ESC. Рекомендации ESC по ведению взрослых пациентов с врожденными пороками сердца 2020. Российскийкардиологическийжурнал. 2021;26(9):4702. http://doi.org/10.15829/1560-4071-2021-4702
2. Choudhary P, Canniffe C, Jackson DJ, Tanous D, Walsh K, Celermajer DS. Late outcomes in adults with coarctation of the aorta. Heart 2015;101:1190-1195. https://doi.org/10.1136/heartjnl-2014-307035
3. Li W, West C, McGhie J, van den Bosch AE, Babu-Narayan SV, Meijboom F, Mongeon FP, Khairy P, Kimball TR, Beauchesne LM,, Ammash NM, Veldtman GR, Oechslin E, Gatzoulis MA, Webb G. Consensus recommendations for echocardiography in adults with congenital heart defects from the International Society of Adult Congenital Heart Disease (ISACHD). Int J Cardiol 2018;272:77-83. https://doi.org/10.1016/j.ijcard.2018.07.058
4. Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, et al. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019 Apr 2;73(12):1494-1563. https://doi.org/10.1016/j.jacc.2018.08.1028
5. Coarctation of the aorta: clinical guidelines. 2023:12-14. (In Russ.)
6. Matchin Yu. G., Kozlov S. G., Lyakishev A. A., et al. Favorable course of coarctation of the aorta. Cardiology. 1991;31(12):105- 106. (In Russ.)
7. Kondrashin S.A., Gagarina N.V. Complex radiological diagnosis of aortic coarctation in an adult patient. Russian electronic journal of radiology. 2013;3(1):75-77. (In Russ.)
8. Korneeva N.V., Morozova A.M., Udinkan A.G., Belykh D.G., Mikhaylova J.V. The case of primary diagnosis of aortic coarctation in a 39-year-old woman. Regional blood circulation and microcirculation. 2022;21(4):42-49. (In Russ.) https://doi.org/10.24884/1682-6655-2022-21-4-42-49
Review
For citations:
Korobkova I.Z., Buldakova N.V., Matchina A.Yu., Stukalova O.V., Gaman S.A. The value of chest x-ray in the diagnosis of aortic coarctation. Eurasian heart journal. 2025;(1):58-62. (In Russ.) https://doi.org/10.38109/2225-1685-2025-1-58-62