Abstract
A 24-year-old woman was diagnosed with high blood pressure when she was 14 years old. During the last 4 years, she has experienced progressive symptoms of lower extremity weakness and fatigue and cannot do any heavy exercise. On physical examination, she presented with absent bilateral femoral pulses. Ultrasound ankle-brachial index (ABI) with Doppler of the lower extremities showed diffuse monophasic waveforms and diminished ABI bilaterally (right ABI = 0.68, left ABI = 0.65). A computed tomography angiography confirmed a severe narrowing of the aorta just distal to the origin of the left renal artery consistent with the diagnosis of middle aortic syndrome.
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