Background: Coarctation of the aorta (CoA) is a congenital narrowing of the proximal descending aorta, which may express itself as resistant hypertension in children and young adults.
Case description: A 25-year old female is known with hypertension for 9 years. Due to persistent hypertension despite telmisartan and amlodipine, she is referred to the outpatient clinic internal medicine, where a systolic murmur is heard. Consequently, she is referred to the cardiologist, who identifies a well-functioning bicuspid aortic valve and a severe CoA with extensive collateral circulation. The CoA is treated by stent implantation. After 7 months, the patient is normotensive without any antihypertensive medication.
Conclusion: Hypertension in children and young adults is a rare finding and often has a secondary cause. CoA is characterized by a combination of hypertension and a systolic blood pressure gradient between upper and lower extremities. Early diagnosis and treatment are crucial to avoid late cardiovascular complications.