Cardiac Surgery 31-40

Q31 ) Not a finding in young adult with coarctation of aorta
A) Dimnished femoral pulse
b) Post murmur between the scapula
c) High BP in left arm
d) Peripheral cyanosis


31) d

The usual site for aortic coarctation is just distal to the left subclavian artery origin, any pulses
distal to this site is diminished and the first site to check pulses is the femoral arteries. The site
of coarctation is close to the vertebral column between the scapulae,

Usually there is a pressure gradient across the coarc. Leading to higher pressures in the upper limbs and lower in
lower limbs. Peripheral cyanosis is usually caused by low oxygen saturation due to mixing of
saturated and desaturated blood through an anomalous connection between systemic and
pulmonary circulation ( TOF, TAPVC, TGA etc..) or due to pulmonary diseases and doesn’t
occur in pure aortic coarctation unless associated with an another anomaly like above.

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