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Recognition of Coarctation of the Aorta: A Continuing Challenge for the Primary Care Physician

Recognition of Coarctation of the Aorta: A Continuing Challenge for the Primary Care Physician Abstract • Coarctation of the aorta (CoA) in its classic form presents with characteristic and distinctive physical findings. However, In our survey less than one [ill]third of 106 consecutive patients in whom CoA was ultimately diagnosed hadad the correct diagnosis made by the referring physician. Our survey suggests that in asymptomatic infants and children,ildren, an incomplete physical examination explains the diagnostic failure.ure. However, in Infants presenting with heart failure, the diagnostic signs of CoA may be obscured and more difficult to recognize even when specifically sought. This survey reaffirms the need or specific physical examination techniques in all infants and children to faciltate early recognition of CoA; these include the palpation of pulses and proper measurement of blood pressure. (AJDC 1987;141:1201-1204) References 1. Rudolph AM: Congenital Diseases of the Heart . Chicago, Year Book Medical Publishers Inc, 1974, pp 329-349. 2. Riemenschneider TA, Linde LM: Aorta, coarctation , in Bergsma D (ed): Birth Defects Compendium . New York, Alan R Liss Inc, 1979, pp 103-104. 3. Strafford MA, Griffiths SP, Gersony WM: Coarctation of the aorta: A study in delayed detection . Pediatrics 1982;69:159-163. 4. Hartmann AF Jr, Goldring D, Strauss AW, et al: Coarctation of the aorta , in Moss AJ, Adams FH, Emmanouilides GC (eds): Heart Disease in Infants, Children and Adolescents , ed 2. Baltimore, Williams & Wilkins, 1977, pp 199-209. 5. Talner NS, Berman MA: Postnatal development of obstruction in coarctation of the aorta: Role of the ductus arteriosus . Pediatrics 1975;56: 562-569. 6. Gersony WM: Coarctation of the aorta, in Adams FH , Emmanouilides GC (eds): Heart Disease in Infants, Children and Adolescents , ed 3. Baltimore, Williams & Wilkins, 1983, pp 188-199. 7. McNamara DG, Rosenberg HS: Coarctation of the aorta , in Watson H (ed): Pediatri[ill] Cardiology . London, Lloyd-Luke Ltd, 1968 pp 175-223. 8. Mathew R, Simon G, Joseph M: Collatera[ill] circulation in coarctation of the aorta in infanc[ill] and childhood . Arch Dis Child 1972;47:950-953.Crossref 9. Task Force on Blood Pressure Control [ill] Children: Report of the Second Task Force [ill] Blood Pressure Control in Children—1987 . Pediatrics 1987;79:1-25. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Recognition of Coarctation of the Aorta: A Continuing Challenge for the Primary Care Physician

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1987.04460110071025
Publisher site
See Article on Publisher Site

Abstract

Abstract • Coarctation of the aorta (CoA) in its classic form presents with characteristic and distinctive physical findings. However, In our survey less than one [ill]third of 106 consecutive patients in whom CoA was ultimately diagnosed hadad the correct diagnosis made by the referring physician. Our survey suggests that in asymptomatic infants and children,ildren, an incomplete physical examination explains the diagnostic failure.ure. However, in Infants presenting with heart failure, the diagnostic signs of CoA may be obscured and more difficult to recognize even when specifically sought. This survey reaffirms the need or specific physical examination techniques in all infants and children to faciltate early recognition of CoA; these include the palpation of pulses and proper measurement of blood pressure. (AJDC 1987;141:1201-1204) References 1. Rudolph AM: Congenital Diseases of the Heart . Chicago, Year Book Medical Publishers Inc, 1974, pp 329-349. 2. Riemenschneider TA, Linde LM: Aorta, coarctation , in Bergsma D (ed): Birth Defects Compendium . New York, Alan R Liss Inc, 1979, pp 103-104. 3. Strafford MA, Griffiths SP, Gersony WM: Coarctation of the aorta: A study in delayed detection . Pediatrics 1982;69:159-163. 4. Hartmann AF Jr, Goldring D, Strauss AW, et al: Coarctation of the aorta , in Moss AJ, Adams FH, Emmanouilides GC (eds): Heart Disease in Infants, Children and Adolescents , ed 2. Baltimore, Williams & Wilkins, 1977, pp 199-209. 5. Talner NS, Berman MA: Postnatal development of obstruction in coarctation of the aorta: Role of the ductus arteriosus . Pediatrics 1975;56: 562-569. 6. Gersony WM: Coarctation of the aorta, in Adams FH , Emmanouilides GC (eds): Heart Disease in Infants, Children and Adolescents , ed 3. Baltimore, Williams & Wilkins, 1983, pp 188-199. 7. McNamara DG, Rosenberg HS: Coarctation of the aorta , in Watson H (ed): Pediatri[ill] Cardiology . London, Lloyd-Luke Ltd, 1968 pp 175-223. 8. Mathew R, Simon G, Joseph M: Collatera[ill] circulation in coarctation of the aorta in infanc[ill] and childhood . Arch Dis Child 1972;47:950-953.Crossref 9. Task Force on Blood Pressure Control [ill] Children: Report of the Second Task Force [ill] Blood Pressure Control in Children—1987 . Pediatrics 1987;79:1-25.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Nov 1, 1987

References