Best Cases: Congenital Heart Disease-A Case of Middle Aortic Syndrome: The Importance of Thinking “Outside of the Box”

A Case of Middle Aortic Syndrome: The Importance of Thinking “Outside of the Box”

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Video Summary

An 18-year-old woman from Bangladesh was found to have hypertension, absent femoral pulses, and intermittent leg numbness. Echocardiography suggested abnormal abdominal aortic flow, prompting MRI/MRA with an extended field of view. Imaging revealed suprarenal middle aortic syndrome: severe narrowing of the abdominal aorta above the celiac artery, with no involvement of the renal or other visceral arteries. She underwent angioplasty and stent placement via the right femoral artery, leading to improved blood pressure, pulses, and symptoms. The case highlights the need for clinical suspicion, tailored MRI protocoling, and collaboration to diagnose rare aortic disease.

Keywords

middle aortic syndrome

abdominal aortic stenosis

hypertension

MRI/MRA

angioplasty stent placement