**Question:** All are true about coarctation of aorta except -

A. A coarctation of the aorta is a congenital heart defect where the aorta is narrowed between the left subclavian artery and the renal arteries.
B. It typically presents during childhood or adolescence with hypertension in the upper extremities and hypotension in the lower extremities.
C. The treatment involves surgical intervention, usually via the median sternotomy approach.
D. Coarctation of the aorta is a rare condition affecting adults only.

**Correct Answer:** D. Coarctation of the aorta is a rare condition affecting adults only.

**Core Concept:**
Coarctation of the aorta is a congenital heart defect where the aorta is narrowed, typically between the left subclavian artery and the renal arteries. It is a common congenital heart defect, particularly in infants and children, but can also occur in adults.

**Why the Correct Answer is Right:**
Coarctation of the aorta affects individuals of all ages, not just adults. The condition can present during childhood or adolescence with hypertension in the upper extremities and hypotension in the lower extremities due to reduced blood flow to the lower body. In adults, the symptoms may be less obvious, and the diagnosis may be made incidentally during imaging studies or workup for unrelated conditions.

**Why Each Wrong Option is Incorrect:**
A. Coarctation of the aorta is a common congenital defect affecting infants and children as well as adults.
B. The condition presents with hypertension in the upper extremities and hypotension in the lower extremities, which is consistent with its clinical presentation.
C. Surgical intervention is the standard treatment for coarctation of the aorta, addressing the narrowing by widening the aorta or bypassing the constriction, ensuring proper blood flow to the lower body.

**Clinical Pearl:**
While coarctation of the aorta is a common congenital defect, it is not limited to adults. Understanding the clinical presentation, such as hypertension in the upper extremities and hypotension in the lower extremities, is crucial for making an accurate diagnosis in any age group. This can help guide appropriate treatment, which may include surgical intervention such as widening the aorta or bypassing the constriction to ensure proper blood flow to the lower body.