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Coarctation of the aorta — RACP Paediatrics MCQ

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ModerateCardiologyCoarctation of the aortaRACP Paediatrics

A 10-day-old neonate presents with cardiovascular collapse. Blood pressure in the right arm is 85/50 mmHg; in the left leg it is 45/30 mmHg. Femoral pulses are absent bilaterally. There is a systolic murmur heard between the scapulae. What is the most likely diagnosis?

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Correct answer: C — Coarctation of the aorta

Critical coarctation of the aorta presents in the neonatal period when the ductus arteriosus closes. Upper-to-lower limb blood pressure gradient (>20 mmHg systolic), absent femoral pulses, and a systolic murmur between the scapulae are diagnostic. Immediate prostaglandin E1 infusion is required to reopen the ductus.

Reference: RCH Melbourne – 2023 – Congenital Heart Disease CPG; RACP Paediatric Curriculum – Cardiology