Hello there - I'm sorry to hear of your recent troubles. I know how frustrating it can be to not get an answer to what is ailing you, and I am sorry that it has taken so long to get a good diagnosis. It is good, however, that the PE and the pleurisy have resolved. Now I understand why you were wondering about the aberrant subclavian artery!
Coarctation of the aorta usually shows up in infants and children. In essence, it is an abnormal constriction or tightening of the aorta, the largest blood vessel coming out of the heart. Usually, this can lead to someone developing high blood pressure, as the heart tries to compensate for the decreased blood flow to the extremities (because of the constriction) by increasing its pumping pressure. As a result, this is usually repaired in small children so that they do not develop high blood pressure. You do not appear to have developed this, however.
The fact that you also have an aberrant subclavian artery, and you complain of chest/shoulder/arm pain, can mean that the coarctation, combined with the aberrant subclavian is causing these symptoms. These two things can form a ring, of sorts, around other structures in the upper chest, including blood vessels and nerves, that can then possibly lead to the pain that you are describing. They can also wrap around the esophagus (through which we swallow) or the trachea (through which we breathe) leading to trouble with eating or breathing. You haven't mentioned any of these, however. Furthermore, the coarctation and aberrant subclavian could mean that one of the other vessels in your chest is slightly abnormal as well, and as such isn't delivering enough blood to your shoulder/arm/hand, and maybe that's why you have the pain. Altogether, the combination of the two together is very rare.
It is very hard for me to say what the CT surgeon will recommend. This is a rare condition, and only specialists like a CT surgeon will deal with it at all, in my experience. Surgery could be an option, but since you have lived for many years (sorry, I don't remember your age) without any symptoms, you and he/she will have to evaluate carefully what the positives and negatives of surgery could mean. It could provide some relief to your pain, or other symptoms if you have some, but it could be a very large surgery. So you will have to discuss it in detail with him.
I am happy to answer any more questions that you might have, so let me know if you are still feeling unsure. I hope that I have helped explain things somewhat; I know that they can be hard to understand.
Take care
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