Ngongang OC¹, Magny TE¹, Bitchou M¹, Mfeukeu-Kuate L², Wawo YE³, Tsambang L⁵, Wandji J¹, Tchuisseu L², Tchikapa J²,Azabji KM², Nganou CN², Djomou NAF⁴, Boombhi J², Chendjou KL⁴, Jonte P⁴, Ouankou MD, Kingue S, Ngu BK  

Authors’ affiliations:

1. Yaounde University Hospital Center 

2. Faculty of Medicine and Biomedical Sciences - University of Yaounde I

3. Centre Médical Hippodrome Yaoundé

4. Université Des Montagnes : Institut Supérieur des Sciences de la Santé (ISSS)

5. Higher Institute of Medical Technology Nkolondom Yaounde

Background: The aortic coarctation is a congenital malformation of the aorta, characterised by the narrowing of the aorta. Diagnosis is usually posed and treatment done early in life.

Objective: In this case report, we present a late diagnosis of isthmic aortic coarctation in a 21-year-old female.

Clinical presentation: The patient was relatively asymptomatic until she was fortuitously diagnosed with hypertension. Physical examination showed blood pressures of 182/89 mmHg (left arm) and of 194/89mmHg (right arm), a bradycardia of 52 beats/minute. On cardiovascular physical assessment was recorded a systolic murmur of intensity 3/6, posterior over the thoracic spine and sub clavicular space.

Para-clinical assessment: biological exams such as creatininemia and kalemia were normal. The transthoracic echocardiogram showed a stenosis at the isthmic part of the descending aorta, with an increased peak velocity of 3.6 m/s (max gradient = 50 mmHg) and no associated patent ductus arteriosus. Thoracic computerised tomographic (CT) angiography showed an aortic isthmus coarctation with a rounded arch. She was addressed to the Cardiac Center of Saint Elisabeth Catholic Hospital of Shison for a surgical management. Meanwhile, she was placed on combined therapy (Atenolol 50mg and Nifedipine 20mg daily) and a good clinical condition was achieved.

Conclusion: Through this case, we presented a young female with an aortic coarctation fortuitously discovered during the evaluation of an asymptomatic hypertension. Prior to surgical management, Blood pressure controlled was achieved on pharmacological treatment. The particular aspect in this case was the association of a duplicated superior vena cava.

Key words: aortic isthmic coarctation, hypertension, young,echocardiography, CT angiography