Correspondence
Aortic Pseudocoarctation
N Engl J Med 2002; 347:223July 18, 2002
- Article
To the Editor:
In their letter about aortic pseudocoarctation as a cause of refractory hypertension, Joseph et al. (March 7 issue)1 describe aortic narrowing by an intraluminal mass associated with a pressure gradient and weak femoral pulses. Unfortunately, these features actually rule out the diagnosis of aortic pseudocoarctation. This asymptomatic entity is characterized by an elongated, redundant thoracic aorta with buckling distal to the origin of the left subclavian artery. Although aortic pseudocoarctation may indeed be associated with systemic hypertension, it is of no hemodynamic importance itself, and in patients with this condition, there is no pressure gradient across the buckled segment or weakness of the lower-limb pulses.
1 ReferencesSara C. Williams, M.R.C.P.
Good Hope Hospital, Birmingham B75 7RR, United Kingdom1
Joseph M ,Leclerc Y ,Hutchinson SJ . Aortic pseudocoarctation causing refractory hypertension. N Engl J Med 2002;346:784-785
Full Text | Web of Science | Medline
Author/Editor Response
Dr. Hutchison replies:
To the Editor: We used the term “pseudocoarctation” to emphasize that the obstruction was due to an acquired, noncongenital lesion rather than to congenital coarctation, since the lesion had a coarctation-like obstructive effect but was not congenital in origin.
Stuart Hutchison, M.D.
St. Michael's Hospital, Toronto, ON M5B 1W8, Canada
hutchisons@smh.toronto. on. ca
