Learning Radiology xray montage

Pseudocoarctation of the Aorta

General Considerations

  • Congenital and relatively rare
  • Elongated and redundant descending aorta with kinking or buckling of the aorta distal to the origin of the left subclavian artery
  • No obstruction
  • Pressure gradient of less than 30 mmHg
  • No rib notching
  • May be caused by an abnormally long descending aorta

Clinical Findings

  • Asymptomatic

Imaging Findings

  • Junction of arch and descending aorta just past ductus
  • May demonstrate "Figure 3 sign"
  • Since there is no collateral flow needed, there is no rib notching

Differential Diagnosis

  • True adult coarctation of the aorta
    • Pressure differences and rib notching
  • Cervical aortic arch
    • Usually descends on the side opposite the arch


  • No specific treatment for the pseudocoarctation


  • Associated with bicuspid aortic valve, aortic stenosis and insufficiency, PDA, VSD and corrected transposition


Sagittal CT of aorta


Pseudocoarctation. Sagittal contrast-enhanced CT (above) shows kinking of aorta (white arrow)
that produces a picture similar to coarctation without the significant pressure gradient seen in a true coarctation. A surface rendered 3D image below shows the same abnormality. AA=ascending aorta; PA=pulmonary artery.
For these same photos without the arrows, click here and here

For more information, click on the link if you see this icon

Pseudocoarctation of the aorta. Bluemke DA. Cardiology Journal. Vol. 14, No. 2, pp. 205.206, 2007.