Functional aortic coarctation caused by thrombosis within a thoracic aortic aneurysm.

A 67 year old male arteriopath presented with chest pain, a new systolic murmur at the lower left sternal border and loss of leg pulses. Mitral regurgitation and ventricular septal defect were excluded by echocardiographic colour flow Doppler mapping and right heart catheterisation. CT scanning demonstrated a leaking aneurysm of the descending thoracic aorta with stenosis of the proximal lumen due to atheroma and thrombus causing a functional coarctation. The findings were confirmed at surgery.