Mild-Aortic Syndrome : A Cause of Recurrent Abdominal Pain

Mid-aortic syndrome (MAS) is a rare clinical entity that is characterized by coarctation involving the distal thoracic and/or abdominal aorta and its major branches accounting for 0.5–2% of all cases of coarctation of the aorta (1). Renovascular hypertension can be a significant sequelae - it is the main symptomatic presentation of this disease among children and adolescents. We describe a 9-year-old girl who presents with recurrent abdominal pain and symptomatic hypertension. Due to significant left ventricular systolic dysfunction and uncontrolled hypertension, percutaneous balloon angioplasty was performed to treat the coarctation. To our knowledge, this is the first reported case of MAS in Malaysia. This case report highlights the clinical presentation, the role of computed tomography angiogram (CTA) in the diagnosis and current options in the management of MAS.

A Case of Coarctation of the Aorta Treated with Balloon Angioplasty

Balloon dilatation angioplasty was performed in a 15 months old child with isolated discrete unoperated coarctation of the aorta. The peak systolic pressure gradient across the coarctation before balloon angioplasty was 80 mmHg, and immediately after balloon angioplasty it decreased to 19 mmHg. No significant complications were encountered during the procedure. No evidence of aneurysm formation and restenosis was seen on 6 months follow-up examination. Balloon dilatation angioplasty seems to be a safe and effective nonsurgical alternative for relieving the obstruction associated with discrete coarctation of the aorta.