Clinical Case 053: thoracic tortuosity
OK. This is just plain out there. We see some unusual stuff in the remote areas – things you only read about in the books! I am going to put this in the category of medical voyeurism. This is not how we should go about our business, but I had to share these pics!
20 yo with pleuritic chest pain, not much else, but hypertensive BP = 160/90 [not that unusual up here in the tropics]
He managed to get a D-dimer… and then the inevitable CT angiogram (probably PERC negative)
Here is a slice from the CT –
OK – spot diagnosis, what is going on?
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About The Author
Casey Parker
I am a GP working in Broome, NW of Western Australia. I work as a hospital DMO (District Med Officer) doing Emergency, Anaesthestics, some Obstetrics and a lot of miscellaneous primary care. Also on the web as @broomedocs | + Casey Parker | Contact
Coarctation of the aorta?
Coarctation of the aorta; rib notching and dilated tortuous arteries.
Aortic coarctation?
Coarct? CXR would likely have rib notching.
Nice work to you all.
Yep, it is a nice picture of all he collateral vessels around a coarctation.
This chap was an incidental diagnosis.
Love he remote areas – you see all sorts of things which would probably have never made it past the Paeds team in a bigger city.
And yes – he did have a big drop in BP from the right to left arms
Casey