Transthoracic assessment for aortic coarctation. A, Echocardiogram of a
31-year-old woman with BAV and severe aortic coarctation. Suprasternal systolic
still frame shows laminar Doppler flow through the proximal portion of the arch
(“ARCH”) before becoming turbulent flow across a tight coarctation
(arrow) just distal to the left subclavian
(asterisk). B, Suprasternal diastolic still frame shows no
Doppler flow through the proximal portion of the arch but persistent diastolic
turbulent flow across the coarctation (arrow) just distal to
the left subclavian (asterisk). C, Continuous-wave Doppler
signal across the coarctation shows a systolic (measurement) peak gradient of 64
mm Hg through the coarctation, with persistent flow in diastole
(arrow). D, Pulsed-wave Doppler signal of the abdominal
aorta shows a delayed peaking of the systolic signal (line)
with prominent persistent flow in diastole (arrow),
pathognomonic of coarctation.