A 20 year young man presents with exeional dyspnoea, headache, and giddiness. On examination, there is hypeension and LVH. X-ray chest shows notching of the anterior ends of the ribs. Which of the represent the most likely diagnosis?
Correct Answer: Coarctation of the aoa
Description: Patient is showing features of coarctation of aoa. Most common site of coarctation is distal to the origin of the subclan aery near the inseion of ligamentum aeriosum. Children or adult presents with headache, epistaxis, cold extremities and claudication with exercise.On physical examination: a hea murmur, hypeension in the upper extremities and absence, marked diminution or delayed pulsations in the femoral aeries. ECG shows LV hyperophy and Chest X Ray shows notching of the third to ninth ribs. Ref: Harrisons Internal Medicine, 18th Edition, Chapter 343, Page 1925
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