The clinical features associated with coarctation of aorta in older children are the following except –
**Core Concept**
Coarctation of the aorta is a congenital anomaly characterized by the narrowing of the aortic isthmus, typically at the site of the ductus arteriosus. This narrowing leads to increased resistance to blood flow and subsequent hypertension in the upper body, with decreased systemic blood pressure in the lower extremities.
**Why the Correct Answer is Right**
In older children with coarctation of the aorta, the clinical features can be attributed to the long-standing effects of the narrowed aortic lumen. These features include:
* Upper body hypertension due to the increased peripheral resistance in the upper body, which is a direct result of the coarctation.
* Lower body hypotension due to the decreased systemic blood pressure in the lower extremities, which is a consequence of the narrowed aortic lumen.
* Delayed or absent pulse in the lower extremities, which is a result of the reduced blood flow to the lower body.
* Weak or delayed femoral pulses, which is a consequence of the reduced blood flow to the lower body.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because coarctation of the aorta is often associated with hypertension in the upper body, not hypotension.
**Option B:** This option is incorrect because delayed or absent pulse in the lower extremities is a common feature of coarctation of the aorta, not a rare occurrence.
**Option C:** This option is incorrect because weak or delayed femoral pulses are a direct consequence of the reduced blood flow to the lower body in coarctation of the aorta.
**Clinical Pearl / High-Yield Fact**
A key clinical feature of coarctation of the aorta is the presence of a "rib notching" on chest radiographs, which is a result of the collateral circulation that develops in response to the narrowed aortic lumen.
**Correct Answer: D.