International Journal in Physical and Applied Sciences Volume 06 Issue 03, March 2019 ISSN: 2394-5710 Impact Factor: 4.657 Journal Homepage: http://ijmr.net.in, Email: irjmss@gmail.com Double-Blind Peer Reviewed Refereed Open Access International Journal 30 International Journal in Physical and Applied Sciences http://ijmr.net.in, Email: irjmss@gmail.com UNCOMMON CASE RAPPORT OF ACCIDENTAL DISCOVERY DURING A PREGNANCY OF AORTA COARCTATION Salma Bellamqaddam; Rachida Nhiri, Omar Elmahi, Adnane Benzirar,NohaElouafi Mohammed IV Teatchinghospital, Department of cardiology ,Laboratory of Epidemiology, ClinicalResearch and Public Health, UniversityMoahmmed I, Oujda Moroc Introduction Coarctation of the aorta is a common congenital malformation with an estimated incidence of 3.2 per 10,000 births (1). It is a narrowing of the aorta that affects in most cases the isthmus of the aorta, downstream of the birth of the left subclaviculair artery. Achieving the isthmus represents only 0.5 to 2% of all coarctations (2). It is very often discovered in children. In the absence of management the evolution is fatal; this diagnosis is carried out exceptionally in pregnant women and hypertensives. We report a case diagnosed in a young woman during a pregnancy our research methodology is based on Evidence Basis Medicine . Observation: We report a case of coarctation of the aorta discovered incidentally in a patient aged 35, pregnant with an 8-week pregnancy, hypertensive known for 5 months poorly followed.Admitted to emergencies for the installation quickly progressive ptosis left. The general admission examination revealed BP at 240/110 mmHg in both upper limbs, in an athletic chest patient with slender extremities. Cardiac auscultation found intense, medio-thoracic murmur, radiating to the supraclavicular troughs and back. The femoral pulses are perceived, their amplitude is low contrasting with radial pulses which are very wide. Electrocardiogram shows left ventricular hypertrophy. The chest x-ray showed cardiomegaly with a sub-diaphragmatic tip and ribs at the 6th left and 7th and 8th right sides (Figure 1). Echocardiography identifies an unextracted left ventricle with little hypertrophy with preserved systolic function (60% EF), minimal mitral insufficiency. In addition, the aortic valve is tricuspid, without stenosis or leakage. The diagnosis of coarctation was suspected in this clinical picture and confirmed by CT angiography, which showed a very tight and short stenosis of the aortic isthmus with presence of a left intra-cavernous carotid artery aneurysm measuring 32 mm × 30 mm mm pushing the oculomotor nerves in their cavernous paths without signs of rupture (Figure 2). Therapeutic interruption of pregnancy was indicated in this patient then the patient underwent angioplasty with placement of a Palmaz stent (4.6 on 40 mm) by double percutaneous radial left and right femoral with a good agiographic result and recovery of femoral and distal pulses (Figure 3,4). The blood pressure figures went down and the blood pressure was stabilized by a low dose calcium channel blocker. CT scan at 2 weeks showed good permeability of the stent area and diameter stability of the carotid aneurysm which will be programmed for embolization treatment due to its diameter and compressive nature (Figure 5) . Discussion Coarctation of the aorta accounts for 6-8% of congenital heart disease, and is the most common congenital heart disease in pregnant women (1). The discovery of aortic coarctation is classically associated with high maternal mortality (3 to 10% depending on authors), with risk of rupture or aortic dissection, but also rupture of