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Infant with epistaxis and absent femoral pulses
1Department of Emergency Medicine, West Virginia University, Morgantown 26506-9149, USA.
Insights
Coarctation of the aorta, a congenital heart defect, can cause heart failure or remain undetected. Early identification through physical exam findings like murmurs and blood pressure differences significantly improves infant survival rates.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Defects
- Vascular Abnormalities
Background:
- Coarctation of the aorta is a congenital narrowing of the aortic arch.
- It can present in infancy with heart failure or remain latent into adulthood.
- Early diagnosis is crucial for improved patient outcomes.
Observation:
- An infant presented with epistaxis (nosebleeds).
- Physical examination revealed findings suggestive of coarctation of the aorta.
- This highlights the importance of thorough physical assessment in infants.
Findings:
- A cardiac murmur and differential blood pressure between upper and lower extremities are key indicators.
- While absent femoral pulses are common, they are not consistently reliable.
- Prompt identification based on these physical signs is vital.
Implications:
- Early detection of coarctation of the aorta through physical examination improves survival rates.
- This case underscores the value of recognizing subtle physical findings in pediatric patients.
- Timely diagnosis and intervention can prevent severe complications like congestive heart failure.
Abstract:
Coarctation of the aorta is a congenital cardiac abnormality that can lead to congestive heart failure in early infancy or can go undetected for many years. We discuss the case of an infant who presented to our emergency department with epistaxis and was found to have this lesion based on the physical examination. The identification of this lesion before the onset of symptoms leads to improved survival in these patients. A cardiac murmur and differential blood pressure between upper and lower extremities are the most reliable physical findings for identifying patients with coarctation of the aorta. Absent femoral pulses are a hallmark of this lesion, but not a dependable finding.