Last reviewed: 7 Apr 2021
Last updated: 23 Jan 2018



History and exam

Key diagnostic factors

  • hypertension presenting at a young age or resistant to treatment
  • diminished lower extremity pulses
  • differential upper and lower extremity blood pressure (BP)

Other diagnostic factors

  • systolic ejection murmur
  • male gender
  • genetic syndrome
  • claudication
  • headache
  • systolic ejection click
  • other cardiac anomalies

Risk factors

  • male gender
  • young age
  • FHx
  • Turner's syndrome
  • DiGeorge's syndrome
  • hypoplastic left heart syndrome
  • Shone's complex
  • PHACE syndrome

Diagnostic investigations

Investigations to consider

  • computed tomography (CT) angiography
  • magnetic resonance angiography
  • cardiac catheterisation

Treatment algorithm


Jeffrey Gossett

Director Heart Failure, Heart Transplantation

Professor of Pediatrics

Division of Pediatric Cardiology

University of California, San Francisco

San Francisco



JG declares that he has no competing interests.

Dr Jeffrey Gossett wishes to gratefully acknowledge Dr Anna Kamp, a previous contributor to this topic. AK declares that she has no competing interests.

Peer reviewersVIEW ALL

Clinical Assistant Professor of Pediatrics

University of Michigan

Ann Arbor



RA declares that he has no competing interests.

Consultant Paediatric Cardiologist and Honorary Senior Lecturer

Great Ormond Street Hospital and Institute of Child Health




SK declares that he has no competing interests.

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