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Coarctation of the Aorta — RACP Paediatrics MCQ

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ModerateCardiologyCoarctation of the AortaRACP Paediatrics

A 2-week-old neonate presents with poor feeding, tachypnoea, and grey/mottled appearance. Femoral pulses are absent. SpO2 is 98% on the right hand and 82% on the left foot. What is the most likely diagnosis?

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Correct answer: A — Coarctation of the aorta

Absent femoral pulses with a significant pre/post-ductal SpO2 difference (higher in right upper limb than lower limbs), poor feeding, and circulatory collapse in a neonate is classic for critical coarctation of the aorta presenting after ductal closure. Management includes prostaglandin E1 infusion to reopen the ductus arteriosus, resuscitation, and urgent surgical repair.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Coarctation of the Aorta