An unusual and catastrophic presentation of coral reef aorta
Coral reef aorta (CRA) is a rare condition characterized by atherosclerosis and overt calcification of the aorta leading to severe luminal stenosis of the vessel.

Most patients present with hypertension and intermittent claudication at the time of diagnosis. Risk factors associated with this condition are essentially the same as those associated with atherosclerosis. However, no unique condition seems to predispose an individual to develop CRA.

Published in the European Heart Journal Case Reports, the
authors present the case of a patient known for rheumatoid arthritis (RA) treated with long-term systemic corticosteroids who presented with a shock of unknown aetiology and left ventricular ejection fraction of 10%. Conventional and computed tomography angiography showed a CRA with subtotal lesion of the aortic arch that led to cardiogenic shock.

Learning points
• Coral reef aorta (CRA) is a condition of extreme atherosclerosis and calcification of the aorta that can present with severe post-aortic valve obstruction.

• Rheumatoid arthritis and long-term use of corticosteroids are risk factors for atherosclerosis and can possibly play a role in the development of CRA.

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