A 48-year-old male patient underwent surgical correction of interrupted CoA at the age of 22 years using EABG from the LSCA to the descending aorta. He presented with shortness of breath. The patient was found to be hypertensive with a BP of 170/90 mmHg on both arms. The BP in the lower limbs was 125/85 mmHg with obvious brachiofemoral delay. The patient was taking amlodipine 10 mg and valsartan 160 mg, both once a day. The ECG revealed LV hypertrophy. His TTE revealed normal LV systolic function, with LV hypertrophy and impaired relaxation. A CT angiography revealed stenosis at the proximal anastomosis site of the EABG (Figure ).\nThe plan was to proceed with cardiac catheterization and stenting the proximal stenosis after measuring the gradient but the patient refused any kind of intervention. The patient was sent home after adding a third antihypertensive medication, which wass bisoprolol 5 mg once a day. After six months, the patient's symptoms improved and his BP was 145/80 mmHg. His repeated TTE revealed no major changes.
A 46-year-old lady underwent CT chest abdomen and pelvis for breast cancer staging. The CT was reported as free of secondary pathology; however, the below-discussed findings were observed.\nThe CT scan shows the infrarenal tract of the IVC localised on the left side of the aorta. This left paramedian IVC is of normal calibre and crosses the middle line at the level of the celiac trunk, behind the aorta (). At T 12, the IVC continues its way up to the chest as Azygos vein, passing through the aortic hiatus of the diaphragm. No embryologic remnants of the supracardinal veins are noted on the right side of the aorta. A large vein is located ventromedially to the ureter on both sides, consistent with large ovarian veins. Furthermore, the right renal vein follows an anomalous course, as it is situated posteriorly to the aorta to drain into the left-sided IVC. Finally, a partial duplication of the left ureter is noted ().