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Young Man With Coarctation of the Aorta

To identify the key insights or developments described in this article
1 Credit CME

A man in his 20s presented to the emergency department with asymptomatic severe hypertension. Antihypertensive drug therapy was started. Workup for secondary hypertension, including echocardiography and contrast computed tomography, was performed (Figure). A postductal coarctation of the aorta was diagnosed, and the patient underwent successful aortic stent placement.

Double-orifice mitral valve (DOMV) is a rare congenital cardiac defect (1% of all types of congenital heart disease). Three varieties have been described: complete bridge, incomplete bridge, and an eccentric type.1 Of patients with DOMV, mitral regurgitation can be found in up to 43% and stenosis in 13%. However, patients rarely need surgical treatment in the absence of associated defects.13 A bicuspid aortic valve can coexist as it is the most common congenital valvular heart disease associated with coarctation of the aorta.2,3

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Article Information

Published Online: May 3, 2023. doi:10.1001/jamacardio.2023.0853

Corresponding Author: Hugo Rodriguez Zanella, MD, Cardiology, Echocardiography Department, National Institute of Cardiology Ignacio Chavez, Juan Badiano 1, Belisario Domínguez Sección XVI, Mexico City, Tlalpan 14080, Mexico (drzanella@gmail.com).

Conflict of Interest Disclosures: None reported.

References
1.
Baño-Rodrigo  A , Van Praagh  S , Trowitzsch  E , Van Praagh  R .  Double-orifice mitral valve: a study of 27 postmortem cases with developmental, diagnostic, and surgical considerations.   Am J Cardiol. 1988;61(1):152-160. doi:10.1016/0002-9149(88)91322-7PubMedGoogle ScholarCrossref
2.
Linka  AZ , Fatio  R , Attenhofer Jost  C .  Images in cardiology: double orifice mitral valve.   Heart. 2000;84(3):244. doi:10.1136/heart.84.3.244PubMedGoogle ScholarCrossref
3.
Stout  KK , Daniels  CJ , Aboulhosn  JA ,  et al.  2018 AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.   J Am Coll Cardiol. 2019;73(12):e81-e192. doi:10.1016/j.jacc.2018.08.1029PubMedGoogle ScholarCrossref
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Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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