Hidden cause of hypertension: aortic coarctation in an adolescent

Aortic coarctation is a congenital heart defect characterized by narrowing of the aortic isthmus, often remaining undiagnosed in childhood and adolescence. Aim. To describe a clinical case of diagnosis and treatment of aorta coarctation in the adolescent.
Materials and methods. This article presents a clinical report of a 15-year female patient with arterial hypertension resistant to standard therapy. The diagnosis of aortic coarctation was confirmed through comprehensive examination, including echocardiography, 24-hour blood pressure monitoring, and contrast-enhanced computed tomography.
Results. The patient successfully underwent surgical correction in the form of resection of the coarctation with aortic prosthetic grafting.
Conclusion. This case highlights the importance of excluding secondary causes of hypertension in adolescents, especially when treatment resistance is observed, and underscores the need for a multidisciplinary approach and modern diagnostic methods for the timely detection and management of congenital heart defects.

aortic coarctation, arterial hypertension, adolescent, congenital heart defects, surgical correction, diagnosis

1. Almansouri N.E., Awe M., Rajavelu S., Jahnavi K., Shastry R., Hasan H., et al. Early diagnosis of cardiovascular diseases in the era of artificial intelligence: an in-depth review. Cureus. 2024; 16(3): e55869. https://doi.org/10.7759/cureus.55869

2. Марцевич С.Ю., Навасардян А.Р., Лобастов К.В., Микаелян М.В., Михайленко Е.В., Суворов А.Ю. и др. Систематический обзор и метаанализ: критический взгляд на методологию проведения. Рациональная фармакотерапия в кардиологии. 2023; 19(4): 382–97. https://doi.org/10.20996/1819-6446-2023-2923 https://elibrary.ru/whyfsz

3. Moll J.C., Bohlken J., Kostev K. Prevalence of and factors associated with hypertension in children and adolescents as observed by German pediatricians – a case-control study. Children. 2025; 12(3): 348. https://doi.org/10.3390/children12030348

4. Song P., Zhang Y., Yu J., Zha M., Zhu Y, Rahimi K., et al. Global prevalence of hypertension in children. A systematic review and meta-analysis. JAMA Pediatr. 2019; 173(12): 1154–63. https://doi.org/10.1001/jamapediatrics.2019.3310

5. Falkner B., Gudding S.S., Chair V., Baker-Smith C.M., Brady T.M., Flynn J.T., et al. Pediatric primary hypertension: an underrecognized condition: a scientific statement from the American Heart Association. Hypertension. 2023; 80(6): e101–11. https://doi.org/10.1161/HYP.0000000000000228

6. Urbina E.M., Daniels S.R., Sinaiko A.R. Blood pressure in children in the 21st century: what do we know and where do we go from here? Hypertension. 2023; 80(8): 1572–9. https://doi.org/10.1161/hypertensionaha.122.19455

7. Белых Н.А., Кучерявенкова Ю.С., Пизнюр И.В., Лашко А.Ю., Аникеева Н.А. Клинический случай вторичной артериальной гипертензии в практике врача-педиатра. Медицинский вестник Юга России. 2024; 15(4): 66–71. https://doi.org/10.21886/2219-8075-2024-15-4-66-71 https://elibrary.ru/kbjseo

8. Bouhanick B., Sosner P., Brochard K., Mounier-Véhier C., Plu-Bureau G., Hascoet S., et al. Hypertension in children and adolescents: a position statement from a panel of multidisciplinary experts coordinated by the French society of hypertension. Front. Pediatr. 2021; 9: 680803. https://doi.org/10.3389/fped.2021.680803

9. Gajin P., Tanasković S., Nenezić D., Ilijevski N., Radak D. Abdominal aorta coarctation: the first three case reports in our literature. Srp. Arh. Celok. Lek. 2010; 138(7-8): 489–93. https://doi.org/10.2298/sarh1008489g

10. Peng Z., Wei J., Huang X., Chen B., Liang L., Feng B., et al. Epidemiology of congenital heart defects in perinatal infants in Guangxi, China. Int. J. Gen. Med. 2024; 17: 5381–96. https://doi.org/10.2147/IJGM.S466195

11. Бокерия Е.Л., Шумакова О.В., Караваева А.Л., Тимофеева Л.A., Макиева М.И., Зубков В.В. Эффективность неонатального скрининга на критические врожденные пороки сердца путем двузонного измерения систолического артериального давления и сатурации. Доктор.Ру. 2024; 23(6): 13–21. https://doi.org/10.31550/1727-2378-2024-23-6-13-21 https://elibrary.ru/kksmdw

12. Beckmann E., Jassar A.S. Coarctation repair-redo challenges in the adults: what to do? J. Vis. Surg. 2018; 23(4): 76. https://doi.org/10.21037/jovs.2018.04.07

13. Rao P.S. Coarctation of the aorta. Curr. Cardiol. Rep. 2005; 7(6): 425–34. https://doi.org/10.1007/s11886-005-0060-0

14. Посохов И.Н., Мороз-Водолажская Н.Н. «Осциллометрический» метод: что это такое и всем ли пациентам он подходит для измерения артериального давления? Кардиоваскулярная терапия и профилактика. 2024; 23(9): 131–42. https://doi.org/10.15829/1728-8800-2024-4075 https://elibrary.ru/mrnkof

15. Iriart X., Laïk J., Cremer A., Martin C., Pillois X., Jalal Z., et al. Predictive factors for residual hypertension following aortic coarctation stenting. J. Clin. Hypertens. (Greenwich). 2019; 21(2): 291–8. https://doi.org/10.1111/jch.13452

16. Ganigara M., Doshi A., Naimi I., Mahadevaiah G.P., Buddhe S., Chikkabyrappa S.M. Preoperative physiology, imaging, and management of coarctation of aorta in children. Semin. Cardiothorac. Vasc. Anesth. 2019; 23(4): 379–86. https://doi.org/10.1177/1089253219873004