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
critical coarctation
noncritical coarctation
recurrent coarctation
Contributors
Authors
Jeffrey Gossett, MD

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.
Differentials
- Aortic stenosis (AS)
- Interrupted aortic arch
- Left ventricular outflow tract obstruction
More DifferentialsGuidelines
- ACR appropriateness criteria: congenital or acquired heart disease
- Guidelines for cardiovascular intervention in adults with congenital heart disease
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