Multimodality Imaging Approach in Diagnosis and Follow-Up of Aortic Coarctation in Adulthood

Aortic coarctation (CoA) comprises local narrowing of the aortic lumen, which is located at the level of the isthmus in 95% of patients and accounts for 5 to 8% of live births with congenital heart disease. It can be associated with other congenital defects, such as a bicuspid aortic valve (BAV), and in adulthood should be considered a secondary cause of hypertension in patients younger than 40 years, particularly in the presence of severe or resistant hypertension, in accordance with current hypertension guidelines. A correct diagnosis is necessary for the proper assessment and management of these patients. A multimodality imaging approach using ultrasound, computed tomography (CT), and MRI allows for accurate and effective diagnosis. The purpose of this review is to describe different non-invasive imaging techniques and highlight their advantages and disadvantages, aiming to provide a guide to clinicians and cardiovascular imaging specialists in choosing the best imaging tools to use in adults with native CoA.