Four Extremity Blood Pressure
Is four extremity blood pressure indicative of coarctation?
The clinical diagnosis of coarctation of the aorta is initially on characteristic blood pressure findings. The characteristic findings are based on the location of the aorta coarct. Most commonly, systolic hypertension is identified in the upper extremities with diminished or delayed pulses, and low or unobtainable blood pressure readings in the lower extremities. However, systolic hypertension can be identified in the right arm with diminished or delayed pulses in the left arm and the lower extremities (Agarwala, Bacha, Cao, & Hijazi, 2015).
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.