Introduction Coarctation the aorta is typically thought to be a childhood disease and very rarely present in adults. However, emergency medicine physicians must keep a broad differential diagnosis when faced with a young or elder patient with signs and symptoms of acute congestive heart failure.

Case Report We report a case of a previously healthy male patient who presented to the emergency department with sudden onset of palpitation and ascending pain through lower extremities associated with giddiness and headache. The patient was examined and diagnosed with coarctation of the aorta. Management with interventional procedure was done and patient improved with symptomatic relief.

Discussion Coarctation of the aorta in adults are asymptomatic until an insidious injury occurs and will typically present with rare complains.

Conclusion This case demonstrates the importance of considering advanced imaging as a useful diagnostic tool and importance of early interventional procedure to improve outcome of the patient.

Keywords: Gourd shaped appearance; Post stenotic dilation; Percutaneous catheter balloon dilation with stent placement; Blood pressure difference between the upper and lower extremities and pulse delay; Case report.