Last reviewed: 25 Sep 2021
Last updated: 29 Sep 2021

Summary

Definition

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 sex
  • genetic syndrome
  • claudication
  • headache
  • systolic ejection click
  • other cardiac anomalies

Risk factors

  • male sex
  • young age
  • family history
  • Turner syndrome
  • DiGeorge syndrome
  • hypoplastic left heart syndrome
  • Shone complex
  • PHACE syndrome

Diagnostic investigations

1st investigations to order

  • electrocardiogram (ECG)
  • chest x-ray (CXR)
  • echocardiogram

Investigations to consider

  • computed tomography (CT) angiography
  • magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA)
  • cardiac catheterization

Treatment algorithm

Contributors

Authors

Jeffrey Gossett, MD
Jeffrey Gossett

Vice President and System Chief of Pediatric Cardiology

Professor of Pediatrics

Division of Pediatric Cardiology

Cohen Children’s Medical Center, Northwell Health

New Hyde Park

NY

Disclosures

JG declares that he has no competing interests.

Acknowledgements

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

Disclosures

AK declares that she has no competing interests.

Peer reviewers

Ranjit Aiyagari, MD

Clinical Assistant Professor of Pediatrics

University of Michigan

Ann Arbor

MI

Disclosures

RA declares that he has no competing interests.

Sachin Khambadkone, MD, DCH, DNB

Consultant Paediatric Cardiologist and Honorary Senior Lecturer

Great Ormond Street Hospital and Institute of Child Health

London

UK

Disclosures

SK declares that he has no competing interests.

Use of this content is subject to our disclaimer