Coarctation of the Aorta: The Daily PANCE Blueprint
A child is found to have higher blood pressure in the arms than in the legs, and pulses are bounding in the arms but decreased in the legs. The most likely condition is?
A. Peripheral Artery Disease
B. Aortic Stenosis
C. Coarctation of the Aorta
D. Renal Artery Stenosis
E. Hypertrophic Cardiomyopathy
Answer and topic summary
The answer is C. Coarctation of the Aorta.
Coarctation of the aorta involves a narrowing of the aorta that may occur anywhere along its length. The vast majority of cases occur just below the origin of the left subclavian artery.
- The classic clinical sign of coarctation of the aorta is higher blood pressure in the arms than in the legs and pulses that are bounding in the arms but decreased in the legs
- CXR: notching of ribs, dilated L subclavian artery, and post-stenotic aortic dilation. Aortic shadow shows “figure of 3 sign” due to dilatation of the proximal and distal segments surrounding the coarctation
- Definitive Diagnosis is by echocardiography or by CT or MR angiography
- Treatment is balloon angioplasty with stent placement or surgical correction – usually performed between the ages of 2 and 4 years
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Cardiology ⇒ ⇒
Also covered as part of the Pediatric EOR topic list
