2 Coarctation with anomalous post-coarctation origin of the right subclavian artery.

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Q. A 16 year old with headache and hypertension has a chest radiograph which demonstrates plain radiographic signs of coarctation of the aorta. Further investigations reveal anomalous post-coarctation origin of the right subclavian artery. The ribs most likely to demonstrate inferior rib notching would be:

a. Left third to ninth ribs

b. Bilateral third to ninth ribs

c. Right third to ninth ribs

d. Bilateral first and second ribs


ANSWER:
Ans : a. Left third to ninth ribs
Due to anomalous origin of right SubClavian artery from the post coarctation segment , there is no collateral flow to the intercostal arteries on the right. Subsequently , there is no right sided rib notching.



Question source : http://www.cambridge.org/aus/catalogue/catalogue.asp?isbn=9780511671395&ss=exc

2 comments:

  1. A left aortic arch with aberrant right subclavian artery is the most common congenital arch anomaly,

    followed by right aortic arch with aberrant left subclavian artery.

    A right aortic arch and associated aberrant left artery can be associated with a left ligamentum arteriosum that forms a complete vascular ring and leads to airway compression.

    A left aortic arch with aberrant right subclavian artery has been described as not being associated with airway compression.

    ReplyDelete
  2. Which of the following causes left sided inferior rib notching?

    a. Preductal Coarctation of Aorta

    b. Post Ductal coarctation of Aorta

    c. Coarctation of aorta in a patient with Left Aortic arch and anomalous post-coarctation origin of the right subclavian artery.

    d. Coarctation of aorta in a patient with Right Aortic arch and anomalous post-coarctation origin of the left subclavian artery.


    Answer C

    ReplyDelete

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