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AETIOLOGY - narrowing of the aorta predominantly gets centrally located the walk point the ductus arteriosus joins the aorta (i.e. truly below the origin of the left subclavian artery); much incident with following abnormalities (i.e. bicuspid aortic valve, aneurysm of the latitude of Wilis); acquired coarctation - one (i.e. soar trauma, Takayasu's disease)

CLINICAL FEATURES

sometimes it is a cause of cardiac failure in the newborn

often asymptomatic until the adulthood

coarctation is suspected when a patients with systemic hypertension is found to delayed femoral pulse (radial-femoral pulse lag) and 30mmHG or greater systolic pressure difference between the right arm and the legs

other signs: headaches, weakness or cramps in the legs, the upper extremities and thorax may be more developed than lower extremities, abnormally large arterial pulsations in the neck

sometimes systolic murmur posteriorly, over the coarctation, ejection systolic murmur in the aortic area (due to bicuspid valve)

collaterals involving the periscapular and intercostal arteries (systolic or continous murmurs over the lateral thoracic wall

CXR - changes in the contour of the aorta ("3 sign"), notching of the under surfaces of the ribs from collaterals (due to erosion by dillated vessels)