Aortic coarctation

Last reviewed: 23 Aug 2023
Last updated: 15 Aug 2023



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)
More key diagnostic factors

Other diagnostic factors

  • systolic ejection murmur
  • male sex
  • genetic syndrome
  • claudication
  • headache
  • systolic ejection click
  • other cardiac anomalies
Other diagnostic factors

Risk factors

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

Diagnostic investigations

1st investigations to order

  • electrocardiogram (ECG)
  • chest x-ray (CXR)
  • echocardiogram
More 1st investigations to order

Investigations to consider

  • computed tomography (CT) angiography
  • magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA)
  • cardiac catheterization
More investigations to consider

Treatment algorithm


critical coarctation


noncritical coarctation

recurrent coarctation



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



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.


AK declares that she has no competing interests.

Peer reviewers

Ranjit Aiyagari, MD

Clinical Assistant Professor of Pediatrics

University of Michigan

Ann Arbor



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




SK declares that he has no competing interests.

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  • Guidelines

    • ACR appropriateness criteria: congenital or acquired heart disease
    • Guidelines for cardiovascular intervention in adults with congenital heart disease
    More Guidelines
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