Atypical coarctation of the abdominal aorta as a cause of acute hypertensive heart failure.

A case of atypical coarctation of the suprarenal aorta with symptoms of acute hypertensive heart failure is reported. A 62-year-old man was admitted because of dyspnea associated with severe hypertension. Chest x ray demonstrated mild pulmonary congestion. Following antihypertensive management, symptoms of congestive heart failure improved. Abdominal computed tomography and digital subtraction angiography undertaken several days later demonstrated a narrowed segment of the suprarenal aorta. Control of hypertension was poor with currently available antihypertensives and a bilateral axillo-femoral bypass operation with artificial grafts was undertaken. Postoperative blood pressure was maintained at a normal level with a small dose of atenolol. The patient had an uneventful hospital course and remains well.