Case A 45-year-old male presents to the ED with acute-onset chest tightness since the previous night. Medical history: Hypertension Examination He is afebrile. HR : 80 beats/minute BP : 202/186 mmHg Higher systolic blood pressure is observed over the upper limbs than over the lower limbs. He experienced mild distress due to pain with moderate chest tenderness. Complete blood cell counts results, including hemocoagulation, and biochemistry tests, are normal.
Electrocardiography showed normal sinus rhythm and left ventricular hypertrophy. Chest radiography reveals no significant abnormalities. CT is suggestive of coarctation of the aorta; it reveals a marked narrowing of the aortic arch with several engorged intercostal arteries. During the CT, the patient experienced urinary incontinence and sudden onset of bilateral lower limb weakness. Lower-extremity motor strength was 2/5…
