Features of coarctation of the aorta (congenital narrowing of the aorta) may be visible on a chest X-ray
Coarctation causes blood flow to be deviated from the upper part of the descending aorta into the intercostal vessels of the 4-8th ribs bilaterally which results in ‘notching’ of their inferior edge
These signs are subtle and so a high degree of clinical suspicion is often required to make the diagnosis