Rapid Review: Coarctation of the Aorta

Coarctation of the Aorta

• Narrowing of descending aorta 
• Sx: headaches, dyspnea, leg claudication
• PE: higher blood pressure in the arms than in the legs, delayed femoral pulse
• ECG: LVH
• CXR: notching of ribs, “3 sign” (indentation of aorta)
• Dx: echo
• Tx: balloon angioplasty with stent placement or surgical correction
• Associated with Turner syndrome, bicuspid aortic valve, and intracranial aneurysms

Sample question:

A 5-year-old girl with Turner syndrome is found to have systolic hypertension. Further examination reveals diminished femoral pulses. Which of the following is the best initial test for establishing the most likely diagnosis?