Which finding would support a diagnosis of coarctation of the aorta in a child?

• A. Absence of femoral pulse
• B. Wide, bounding femoral pulse
• C. Normal pulses in all extremities
• D. Elevated lower extremity temperature

Answer: (B)

Coarctation of the aorta causes high pressure before the narrowing and reduced perfusion beyond it, so the legs often don’t receive enough blood. The most telltale finding in a child is an absent or weak femoral pulse, reflecting diminished distal perfusion and sometimes a noticeable difference in blood pressures between the arms and legs. A wide, bounding femoral pulse would point to conditions with increased stroke volume or a valvular/intracardiac issue like aortic regurgitation or PDA, not CoA. Normal pulses in all extremities and an elevated temperature in the lower extremities don’t fit this condition. In practice, you’d also look for a BP difference between upper and lower extremities and a systolic murmur, with rib notching on X-ray in longer-standing cases.