case_images: PMC11718331_01
case_images: Two-dimensional (2D) transthoracic echocardiography: Image (A): Apical 4-chamber view showing membranous supramitral ring (white arrow). Image (B): Continuous wave doppler across the mitral valve demonstrates severe supravalvular mitral stenosis with a mean diastolic pressure gradient of 12 mmHg.
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case_images: Apical four-chamber view showed a morphologically normal mitral valve (MV), but a supramitral ring was noted, resulting in severe supravalvular mitral stenosis with a mean transmembrane pressure gradient (P-mean) of 12 mmHg [Fig. 1].
case_images: Image (A): Transthoracic short-axis view displays a bicuspid aortic valve. Image (B): Continuous wave doppler across the aortic valve shows oderate aortic stenosis with Vmax at 3.5 m/s.
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case_images: In addition, the maximum jet velocity (Vmax) of 3.5 m per second and a mean pressure gradient of 34 mmHg [Fig. 2].
case_images: Image (A): A suprasternal view of the aorta reveals turbulent blood flow in the discending aorta, consistent with CoA. Image (B): Continuous wave doppler across the coarctation segment, presenting a peak velocity of 4 m/s and an extended speed reduction during diastole (diastolic tail).
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case_images: Suprasternal views were obtained, which demonstrated severe CoA (diameter of approximately 2 mm) distal to the left subclavian artery origin [Fig. 3]. A continuous diastolic flow pattern was noted in the abdominal aorta (indicating CoA) [Fig. 3].
case_images: Two-dimensional (B) and three-dimensional (A) computed tomography scan imaging of coarctation of the aorta showing the discrete narrowing site at the aortic isthmus level.
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case_images: Further investigations, including multi-detector computed tomographic (MDCT) angiography, clearly delineated the presence of severe CoA [Fig. 4].