Aortic coarctation chest x-ray
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S.[2], Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S.[4]
Overview
Aortic coarctation on chest X ray presents with irregular notching of the inferior margins of the posterior ribs resulting from collateral flow through dilated and pulsatile intercostal arteries. An inverted "3" sign of the barium-filled esophagus or a "3" sign on a highly penetrated chest radiograph may be visualized. Signs of congestive heart failure cardiomegaly, pulmonary edema, and prominent pulmonary vasculature are evident on chest radiograph.
Chest X Ray
- Irregularities or notching of the inferior margins of the posterior ribs results from collateral flow through dilated and pulsatile intercostal arteries. These collateral appear after 6 years of age if the coarctation is significant.
- An inverted "3" sign of the barium-filled esophagus or a "3" sign on a highly penetrated chest radiograph may be visualized. Post-stenotic dilation of the aorta results in a classic reverse 3 sign on x-ray. The characteristic bulging of the sign is caused by dilatation of the aorta due to an indrawing of the aortic wall at the site of cervical rib obstruction, with consequent post-stenotic dilation. This physiology results in the reversed 3 image for which the sign is named.[1][2][3]
- Signs of congestive heart failure Cardiomegaly, pulmonary edema,and prominent pulmonary vasculature are evident.
Shown below are the chest X-ray images showing 3 sign and arrows pointing to notching of ribs.
References
- ↑ Sabatine, Marc (February 15, 2000). Pocket Medicine. Lippincott Williams & Wilkins. pp. 256 pages. ISBN 0781716497.
- ↑ Blecha, Matthew J. (August 30, 2005). "General Surgery ABSITE and Board Review (Pearls of Wisdom)". McGraw-Hill. ISBN 978-0071464314.
- ↑ Brady Pregerson (October 1, 2006). "Quick Essentials: Emergency Medicine, 2nd Edition". ED Insight Books. ISBN 0976155273.