Coarctation of the aorta


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Coarctation of the aorta

Cardiovascular system

Vascular disorders

Arterial disease

Angina pectoris

Stable angina

Unstable angina

Myocardial infarction

Prinzmetal angina

Coronary steal syndrome

Peripheral artery disease

Subclavian steal syndrome


Aortic dissection


Behcet's disease

Kawasaki disease


Hypertensive emergency

Renal artery stenosis

Coarctation of the aorta

Cushing syndrome

Conn syndrome


Polycystic kidney disease


Orthostatic hypotension


Familial hypercholesterolemia



Chronic venous insufficiency


Deep vein thrombosis




Vascular tumors

Human herpesvirus 8 (Kaposi sarcoma)


Congenital heart defects

Truncus arteriosus

Transposition of the great vessels

Total anomalous pulmonary venous return

Tetralogy of Fallot

Hypoplastic left heart syndrome

Patent ductus arteriosus

Ventricular septal defect

Coarctation of the aorta

Atrial septal defect

Cardiac arrhythmias

Atrial flutter

Atrial fibrillation

Premature atrial contraction

Atrioventricular nodal reentrant tachycardia (AVNRT)

Wolff-Parkinson-White syndrome

Ventricular tachycardia

Brugada syndrome

Premature ventricular contraction

Long QT syndrome and Torsade de pointes

Ventricular fibrillation

Atrioventricular block

Bundle branch block

Pulseless electrical activity

Valvular disorders

Tricuspid valve disease

Pulmonary valve disease

Mitral valve disease

Aortic valve disease


Dilated cardiomyopathy

Restrictive cardiomyopathy

Hypertrophic cardiomyopathy

Heart failure

Heart failure

Cor pulmonale

Cardiac infections



Rheumatic heart disease

Pericardial disorders

Pericarditis and pericardial effusion

Cardiac tamponade

Dressler syndrome

Cardiac tumors

Cardiac tumors

Cardiovascular system pathology review

Acyanotic congenital heart defects: Pathology review

Cyanotic congenital heart defects: Pathology review

Atherosclerosis and arteriosclerosis: Pathology review

Coronary artery disease: Pathology review

Peripheral artery disease: Pathology review

Valvular heart disease: Pathology review

Cardiomyopathies: Pathology review

Heart failure: Pathology review

Supraventricular arrhythmias: Pathology review

Ventricular arrhythmias: Pathology review

Heart blocks: Pathology review

Aortic dissections and aneurysms: Pathology review

Pericardial disease: Pathology review

Endocarditis: Pathology review

Hypertension: Pathology review

Shock: Pathology review

Vasculitis: Pathology review

Cardiac and vascular tumors: Pathology review

Dyslipidemias: Pathology review


Coarctation of the aorta


0 / 13 complete

USMLE® Step 1 questions

0 / 4 complete

High Yield Notes

9 pages


Coarctation of the aorta

of complete


USMLE® Step 1 style questions USMLE

of complete

A 15-year-old girl is brought to the pediatrician for evaluation of leg pain that is exacerbated by exercise. The patient reports having difficulty keeping up with her classmates while playing soccer at school. She has not started having menses. Her mother had menarche at the age of 12. The patient’s temperature is 37.2°C (99.0°F), pulse is 80/min, respirations are 14/min. Upper extremity blood pressure is 140/81 mmHg, and lower extremity blood pressure is 118/70 mmHg. Physical examination reveals a low posterior hairline, Tanner stage I breasts and webbed neck.  Which of the following additional examination findings will most likely be seen in this patient? 

External References

First Aid








Aneurysms p. 533

coarctation of aorta p. 305

Coarctation of the aorta

labs/findings p. 720

Bicuspid aortic valve

coarctation of aorta and p. 305

Coarctation of aorta p. 305, 306

Turner syndrome p. 661


coarctation of aorta p. 305

Turner syndrome p. 661

coarctation of aorta and p. 305


Content Reviewers

Rishi Desai, MD, MPH


Tanner Marshall, MS

Vincent Waldman, PhD

Coarctation is a fancy way of saying “narrowing,” so a coarctation of the aorta means a narrowing of the aorta. If we look at the heart, we’ve got the right and left atria, the right and left ventricles, the pulmonary artery leaving the right ventricle to go to the lungs, and the aorta leaving the left ventricle to go to the body.

There are two forms of aortic coarctation to be familiar with: an “infant” form and an “adult” form. With the infant form, which accounts for about 70% of cases, the coarctation comes after the aortic arch, which branches off to the upper extremities and to the head, and before the ductus arteriosus. Now, you might be thinking, “Hey, what’s this ductus arteriosus thing doing here?” Well, typically this guy only exists during fetal development and closes after birth, but with infantile coarctation, the ductus arteriosus is usually still open, or patent, so there’s a patent ductus arteriosus. In fact, sometimes this form is also called preductal coarctation.

So, if we draw out a more simplified version of the heart, we’ve got deoxygenated blood coming into the right atrium that flows into the right ventricle. Now, as it’s pumped out of the pulmonary artery, it’s got two choices, right? One option is to go through the patent ductus arteriosus and continue down the aorta; the other option is to continue down the way it’s going. Well, since it’s higher pressure over here on the left side, you might think that the blood would say “thanks, but no thanks,” and keep going down the lower pressure pulmonary artery. Instead, this aortic coarctation adds a little twist. Since the spot right before the ductus arteriosus is narrower, blood flowing from the left side has a harder time going through, so actually there’s high pressure upstream of the coarctation, but low pressure downstream. So, what happens is that blood decides to go this way, through the patent ductus arteriosus and into the lower pressure area in the systemic circulation, and then continues down to the lower extremities, rather than the slightly higher pressure pulmonary artery. This gives you a real sense of exactly how much this coarctation reduces the pressure over on the systemic side.


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