Aortic Coarctation Vs Subclavian atherosclerosis - USMLE Forums
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Old 06-07-2011
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Heart Aortic Coarctation Vs Subclavian atherosclerosis

So in both conditions we find differential pressures between both upper limbs, how could we tell them apart?


is it age? i mean if its elderly, then its not coarcatation, rather its subclavian artery atherosclerosis? and vice versa if its young patient
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Old 06-08-2011
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The radiofermoral delay is a good differentiating point
The hypertension is not a presentation in subclavien artery pathology
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Old 06-08-2011
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perhaps in subclav a athero the hypertension is LIMITED to one limb, and the other is normal
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Old 06-08-2011
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yeah..subclavian athero have claudication when exercise done with effected limb,pulse and bp limbs in differ(low),age,subclavian steal syn

in aortic coarcta..we find typical features like unexplained high bp,chest pain,sudden sob,fainting,nose bleed,unequal arms....
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Old 06-08-2011
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could aortic coarctation be diagnosed in an elderly? shouldnt it be diagnosed early in childhood?
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Old 06-08-2011
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Default Different presentation!

Their presentations are entirely different!

Subclavian artery occlusion: Typically with subclavian steal syndrome!

The patient may present with no symptoms or upper extremity claudication secondary to exertion. If the condition has precipitated a steal syndrome, no symptoms are typically present. The examining physician should be aware of the rare presentation of various neurological symptoms and findings that may be associated with the steal syndromes, including syncope, vertigo, ataxia, sensory loss, visual changes, and stroke, depending on the vessels involved in the steal. The affected upper extremity may or may not demonstrate diminished pulses. Blood pressure differences between the affected and unaffected sides may be noted.

Coarctation on the other hand present as early onset or late onset.

The presentation of patients with coarctation of the aorta (CoA) varies but may be discussed relative to the patients who present early, often with congestive heart failure (CHF), and the patients who present later, most often with hypertension.
http://emedicine.medscape.com/article/895502-clinical

I agree patient's age at onset can also give us a clue!
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