Coarctation of the Aorta
Coarctation of the Aorta is a congenital narrowing of the distal segment on the aortic arch.
Most commonly occurs in infants with over half presenting with heart failure and failure to thrive in the first two months of life.
The murmur is described as a harsh systolic murmur which is heard best just left to the spine posteriorly
In older children with Coarctation of the Aorta there may be additional low pitched continuous (machinery) murmurs from collateral vessels which have formed to compensate from the narrowing.
Some other signs worth remembering include different blood pressures in the arms and a delayed femoral pulse, the latter of which is the reason why on full examination you feel the femoral pulse and the carotid (some do radial) at the same time to check for a delay.
