Testicular pain as an unusual presenting symptom of aortic coarctation: a case report and review of the literature

Coarctation of the aorta is a congenital narrowing of the aortic arch. Clinical presentation includes hypertension and its complications, but genitourinary manifestations such as testicular pain are rare. Early recognition and management are crucial to prevent long-term morbidity. Despite advances in diagnosis and treatment, some cases remain undetected until adulthood, sometimes presenting with atypical symptoms. This underscores the importance of clinicians’ awareness. We present the case of a 27-year-old Ethiopian male who presented with testicular pain and intermittent headaches. Physical examination revealed severe hypertension. Imaging studies confirmed coarctation of the aorta with a bicuspid aortic valve. The patient underwent successful endovascular stenting of the coarctation, except for a small distal arch dissection postoperatively. Currently, he is on regular follow-up, and his blood pressure is controlled with antihypertensive therapy. This case illustrates the importance of recognizing unusual presentations of coarctation of the aorta with testicular pain in young hypertensive adults. Early diagnosis and intervention with endovascular stenting can prevent long-term complications and improve patient outcomes. Clinicians should maintain a broad differential when evaluating resistant hypertension, considering vascular causes even in the absence of classical features.