A 4 1/2- year-old girl always had to wear warm socks even is summer season. On physical examination, it was noticed that she had high blood pressure and her femoral pulse was weak as compared to radial and carotid pulse, a chest radiograph showed remarkable notching of ribs along with their lower borders. This was due to:
Ans. is 'b' i.e. coarctation of Aorta. Cold extremities, high B.P. in upper extremity with marked diminution of pulsations and B.P. in lower extremity is characteristic of Coarctation of Aorta.More facts about Coarctation of AortaMost patients are asymptomatic.Symptomatic patients usually present with foilwing features.Headache dizziness *Epistaxis*Cold extremities and weakness in legs *Claudication with exercise. *Hypertension in upper extremities with marked diminution of pulsation in lower extremities.Mid systolic or continuous murmur over anterior part of chest and back.*Enlarged and pulsatile collateral vessels in intercostal spaces anteriorly in axilla or posteriorly in interscapular area.Upper extremity is more developed than the lower extremity. *Remember that the Cardiac output responds normally to exercise.*Most common site* of Coarctation of Aorta is just distal to origin of left subclavian artery.If it arises above subclavian artery, blood pressure elevation is evident only in right arm.Bicuspid aortic valve* is the most common abnormality associated with coarctation of Aorta.Radiographynotching of inferior surface of ribs*indentation of aorta at site of coarctation and '3' sign* on para mediastinal shadow.Complications:cerebral aneurysmleft ventricular failure*infective endocarditis
Femoral artery thrombosis.
Coarctation of aorta.
Raynaud's disease.
Takayasu's arteritis.
C.V.S.