Differentiating Pseudo-coarctation vs True Coarctation of Aorta

True coarctation must be distinguished from pseudo-coarctation, which presents as an elongated, kinked thoracic aorta in the same juxtaductal region.

The critical differentiating factor is that pseudo-coarctation has no significant pressure gradient across the narrowing, and therefore, these patients will not develop collateral vessels or rib notching.