aortic coarctation

Question 1

define?

Answer 1

narrowing of aorta at the aortic isthmus (distal to the left subclavian artery)

Question 2

clinical features? classic presentation?

Answer 2

classic: chest pain, murmur, HTN (due to low renal flow) in a young patient

brachio-femoral delay
high BP in upper vs lower extremities
cyanosis of LL or after birth if severe

auscultation: ejection systolic murmur at the L posterior hemithorax or continuous murmur at the L infraclavicular area and intrascapular area

Question 3

diagnosis?

Answer 3

BP measurements of upper and lower extremities

echocardiogram for confirmatory test
xray can show rib notching (enlarged collateral vessels compress the ribs, causing pressure atrophy)