%0 Journal Article %A Richard Roger Warne %A Jeremy Sze Luong Ong %A Conor P Murray %T Incidental detection of late presenting co-arctation of the aorta on chest x-ray: the importance of rib notching %D 2012 %R 10.1136/bcr.12.2011.5347 %J BMJ Case Reports %P bcr1220115347 %V 2012 %X A 31-year-old obese male presented to the emergency department with symptoms and signs suggestive of a viral upper respiratory tract illness with a background of low exercise tolerance. Rib notching was identified on plain film chest radiography and subsequent CT of the thorax identified a moderately tight 2-mm juxta-ductal co-arctation of the aorta with multiple enlarged chest wall collaterals. The patient underwent a two-stage percutaneous procedure involving stent insertion and angioplasty up to 16 mm with significant improvement in exercise capacity and a modest reduction in blood pressure. %U https://casereports.bmj.com/content/casereports/2012/bcr.12.2011.5347.full.pdf