Hypertension in a young lady

A young lady, 25, was diagnosed of hypertension after her third follow up in a clinic. Her history was normal. There were no suggestive history of renal diseases, pheochromocytoma, hyperaldosteronism, Cushing's syndrome and other endocrine disorders. Her family members did not have history of hypertension & diabetes mellitus. She denied taking medications such as OCP, steroids and others.

On examination, she appeared to be well and not obese. There were no signs of anaemia or Cushingoid features. Her blood pressure was 160/100 mmHg. Fundi examination was normal. There was no enlargement of thyroid gland. Abdominal examination did not reveal any organ enlargement.

However, on examination of her peripheral pulses. The clinician detected radio-femoral delay. On further auscultation, there was midsystolic murmur heard over the left interscapular space; together with bruit-like sound heard over lateral thoracic wall.The doctor ordered a chest X-ray immediately.

1. What is the clinical diagnosis?

2. What do you expect to see on the chest X-ray?

(Clue: clinical findings)

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