What physical examination finding is indicative of coarctation of the aorta?

In coarctation of the aorta, one hallmark physical examination finding is the difference in pulse quality between the upper and lower extremities. Specifically, the femoral pulses may be diminished or even absent due to the narrowing of the aorta distal to the left subclavian artery, which leads to reduced blood flow to the lower body. Consequently, patients often present with systolic hypertension in the upper body (arms and head) while having lower blood pressure and weaker pulses in the legs.

This pattern stems from the structural abnormality causing the aorta to narrow, affecting how blood is distributed throughout the body. The diminished femoral pulses indicate compromised blood flow to the lower limbs, which is a classic sign associated with this condition.

In contrast, while increased pulse pressure, visible collateral circulation, and bounding pulses can be associated with other cardiovascular conditions, they do not specifically point to coarctation of the aorta in the same way that diminished femoral pulses do. Increased pulse pressure might indicate conditions like aortic regurgitation or other forms of vascular pathology. Visible collateral circulation can occur in longstanding cases but is not as definitive in early diagnosis. Bounding pulses might be seen in states of wide pulse pressure but again are not characteristic of coar