Mid-aortic syndrome in two Saudi children with refractory hypertension: a case report

BACKGROUND: Middle aortic syndrome (MAS) is a rare clinical condition in children that is associated with a significant risk of morbidity and mortality. Delayed diagnosis and inadequate treatment can lead to severe complications, resulting in life-threatening consequences. CASE PRESENTATION: In this paper, we present two cases involving two 10-year-old Saudi girls diagnosed with MAS who presented with systemic hypertension. Echocardiography demonstrated a patent aortic arch; however, it showed abnormal diastolic flow in the descending aorta, which facilitated the diagnosis of MAS. CONCLUSIONS: Even when a paediatric patient shows no symptoms, health care workers should not record unreliable blood pressure readings. These blood pressure readings may indicate the onset of a disease that, if left untreated, could have catastrophic consequences. This report emphasises the rarity and clinical importance of MAS in the paediatric population, aiming to enhance early diagnosis and improve management strategies. Moreover, these findings underscore the critical role of echocardiography in diagnosing MAS.