Article Text

Reminder of important clinical lesson
Undiagnosed coarctation of the aorta as a cause of aortic dissection in the young
  1. Sarah Saunders1,
  2. Dean Harmse1,
  3. Mary Sheppard2
  1. 1
    Derriford Hospital, Histopathology, Derriford Road, Crownhill, Plymouth, Devon, PL6 8DH, UK
  2. 2
    Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
  1. Sarah Saunders, ssaunders2{at}


A 35-year-old man presented to the Emergency Department with a history of severe acute central chest pain and simultaneous bilateral paralysis the legs with double incontinence. There was no significant past medical or family history. A CT scan showed a thoracic dissection of the aorta extending from the aortic root to the aortic bifurcation and in to the common iliac arteries. The patient was consented for an axillo-femoral bypass and was taken to theatre and operated on for 7 hours. The patient unfortunately died under anaesthesia. A hospital post-mortem was requested to identify the cause of the dissection. The patient’s heart was sent to a cardiac pathologist who identified an undiagnosed coarctation of the aorta. Genetic testing was negative for Marfan syndrome.

As a result of the post-mortem, it was recommended that first degree relatives of the deceased undergo ultrasound examination of the cardiovascular system as appropriate to exclude coarctation of the aorta.

View Full Text

Statistics from


  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.