Recognition of coarctation of the aorta. A continuing challenge for the primary care physician
D. G. Thoele, A. J. Muster and M. H. Paul
Department of Pediatrics, Children's Memorial Hospital, Chicago, IL 60614.
Coarctation of the aorta (CoA) in its classic form presents with
characteristic and distinctive physical findings. However, in our survey
less than one third of 106 consecutive patients in whom CoA was ultimately
diagnosed had the correct diagnosis made by the referring physician. Our
survey suggests that in asymptomatic infants and children, an incomplete
physical examination explains the diagnostic failure. However, in infants
presenting with heart failure, the diagnostic signs of CoA may be obscured
and more difficult to recognize even when specifically sought. This survey
reaffirms the need for specific physical examination techniques in all
infants and children to facilitate early recognition of CoA; these include
the palpation of pulses and proper measurement of blood pressure.
