Table 1.

 Presentation of coarctation

• Fetus

- ventricular disproportion

- great vessel disproportion

- associated with other congenital heart disease

- nuchal thickening/chromosomal abnormality (Turner’s syndrome)

• Neonate

- collapse, acidosis

- heart failure

- systolic/continuous murmur conducted to back

- weak or absent femoral pulses

- upper limb hypertension

• Infant

- heart failure

- systolic/continuous murmur conducted to back

- weak or absent femoral pulses

- upper limb hypertension

- cardiomyopathy rarely

• Child, adolescent, and adult

- systolic/continuous murmur conducted to back (collateral murmurs over scapula rarely)

- weak or absent femoral pulses (radio-femoral delay in older patients)

- upper limb hypertension

- exercise intolerance

- leg fatigue and claudication

- cold feet

- cardiac arrest (left ventricular hypertrophy and arrhythmia)

- hypertensive retinopathy

- intracranial bleed

- aortic dissection/rupture

- infective endocarditis