A fatal case of undiagnosed aortic coarctation
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A 29-year-old female presents to the emergency department with sudden onset severe chest pain. The patient has no relevant past medical history or prior imaging and has no primary care physician. Contrast-enhanced CT images show an 8 cm saccular thoracic aortic aneurysm with active extravasation, hemothorax and hemomediastinum. In addition, there is a severe juxtaductal aortic coarctation with numerous well-developed collaterals. Diagnosis is aortic coarctation with a secondary ruptured thoracic aortic aneurysm, active extravasation, hemothorax, and hemomediastinum. Differential diagnosis includes pseudo-coarctation of the aorta and Takayasu arteritis.

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