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



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.

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  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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