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An asymptomatic young man presented with a cardiac murmur and hypertension only in the right arm. Angiograms showed kinking of the aortic arch with a figure-eight appearance consistent with pseudocoarctation. Before the kinked segment, also demonstrated were a stenotic lesion in the aortic arch proximal to the left carotid artery and profound collateral circulations in the right thorax. These findings strongly suggested a rare combination of pseudocoarctation and true coarctation. His hypertension was corrected following surgery with a bypass graft between the ascending aorta and the abdominal aorta.
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