Middle aortic syndrome is a rare cause of aortic coarctation, characterised by progressive segmental or diffuse narrowing of the distal thoracic aorta and/or abdominal aorta, often involving the renal arteries and other visceral arteries. The syndrome is predominantly seen in children and young adults, typically presenting with severe hypertension, congestive heart failure, renal failure, or severe leg claudication. Diagnostic imaging by angiography of the descending and abdominal aorta is the preferred evaluative modality. Here, we report a case of a young man who was admitted to our Cardiology Department with severe hypertension and middle aortic syndrome diagnosed by renal Doppler scan and CT angiography. An adequate blood pressure control was achieved with antihypertensive treatment and surgery.

Severe dilated cardiomyopathy in children may uncommonly be caused by abnormal loading conditions such as mid-aortic pathology and renal artery stenosis. Refractory hypertension and left ventricular dilatation with hypertrophy are important clues to reversible causes. We present a case of dilated cardiomyopathy in a child secondary to mid-aortic syndrome with renal artery stenosis.

Mid-aortic syndrome is an uncommon vascular disease characterised by lower thoracic and upper abdominal aorta stenosis and can occur even in neonatal or infant periods. Here, we report an interesting case of a 2-month-old female with diffuse hypoplasia of the lower abdominal aorta and secondary dilated cardiomyopathy. In our patient, her abdominal aortic narrowing spontaneously normalised over time with the administration of consistent and goal-directed heart failure therapy, supporting adequate growth and natural recovery.

Myhre syndrome is a rare disease secondary to pathogenic variants in SMAD4 gene. It is a multisystem disease characterised by short stature, deafness, joint stiffness, craniofacial dysmorphism, and potential cardiac manifestations. Herein, we report two new paediatric cases of Myhre syndrome who, additionally, presented with mid-aortic syndrome. This confirms and extends the scarce reports describing the association between these two entities.

Mid-aortic syndrome is a rare condition characterised by segmental narrowing of the thoracoabdominal aorta. Here, we demonstrate a case of mid-aortic syndrome in a 30-month-old female who was diagnosed via transesophageal echocardiography after presenting with dilated cardiomyopathy and severe heart failure requiring placement of a left ventricular assist device.

Coarctation of the abdominal aorta is a rare condition with a handful of cases reported in infancy. We report the case of a 4-month-old infant with severe abdominal coarctation who presented with dilated cardiomyopathy. Following successful transcatheter-based stenting of her abdominal aorta, her cardiomyopathy resolved.

In this study, we summarise a case of a myofibroma causing mid-aortic syndrome due to obstruction of the distal thoracic and abdominal aorta leading to severe left ventricular dysfunction. The patient was managed with percutaneous intervention via balloon dilation and stent placement. On follow-up, the patient has normalisation of ventricular function, is off anti-hypertensives, and is being monitored for re-stenosis.