Aortic root aneurysm and aortic arch coarctation: A rare combination in Turner syndrome

A 35-year-old woman presented to our cardiology department for intermittent chest tightness and cough over two months. She was 150 cm tall and weighed 39 kg. A harsh diastolic murmur was heard over the aortic area. The electrocardiogram showed a sinus rhythm without any other abnormalities. Chest radiography (Fig. 1, Panel A) depicted an enlarged cardiac silhouette with protrusion of the aortic node. Transthoracic echocardiography showed a giant aortic sinus aneurysm (7.5 cm in diameter) with severe tricuspid aortic valve regurgitation; the left ventricle was significantly dilated with a reduced ejection fraction of 45% (Fig. 1, Panels B and C). Additionally, the aortic arch had significant tortuosity and stenosis (0.8 cm of minimal luminal diameter, Fig. 1, Panel D) with a peak pressure gradient reaching 65 mmHg (Fig. 1, Panel E). Computed tomography angiography (Fig. 1, Panel F) confirmed the combination of an aortic root aneurysm (7.3 × 8.1 cm in size), aortic arch coarctation, and subsequent 4.2 × 6.1 cm descending aortic aneurysm.Fig. 1