Tardus-parvus Doppler waveform in the renal arteries of an adult patient suggesting aortic coarctation.

A 19-year-old man presented with arterial hypertension without blood pressure difference between his upper and lower extremities. Duplex Doppler sonography was performed to rule out renal artery stenosis and revealed a tardus-parvus pattern in both renal arteries as well as in the abdominal aorta, whereas the left subclavian artery showed a normal waveform, suggesting a more distal obstruction. Aortography confirmed a severe aortic coarctation. Because the typical signs and symptoms of aortic coarctation may not be present, especially in adults, a tardus-parvus pattern in the abdominal aorta and its branches, contrasting with a normal pattern in the supra-aortic arteries, should suggest the diagnosis.