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Coarctation of the aorta — RACP Paediatrics MCQ

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HardCardiologyCoarctation of the aortaRACP Paediatrics

A 9-day-old who was discharged well becomes pale and tachypnoeic after feeds. Femoral pulses are weak, upper limb blood pressure is 92/54 mmHg and lower limb systolic pressure is difficult to obtain. Liver edge is 4 cm below the costal margin. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Coarctation of the aorta with ductal closure

Coarctation can present with shock and heart failure as the duct closes, with weak femoral pulses and upper-lower limb blood pressure discrepancy. An atrial septal defect would not usually cause ductal-dependent systemic perfusion failure in the first days of life. Femoral pulse assessment remains a high-yield examination in an unwell neonate.

Reference: RCH Cardiac emergencies guideline; RACP Knowledge Guides