A nurse is collecting data from an infant who has coarctation of the aorta. Which of the following manifestations should the nurse expect?
A.
Machine-like murmur
B.
Severe cyanosis
C.
Decreased blood pressure in the legs
D.
Pulmonary edema
The correct answer and Explanation is :
The correct answer is C. Decreased blood pressure in the legs.
Explanation:
Coarctation of the Aorta (CoA) is a congenital heart defect characterized by a narrowing of the aorta, typically just after the aortic arch. This condition obstructs the blood flow from the left ventricle of the heart to the lower part of the body, creating specific hemodynamic patterns.
Expected Manifestations:
- Decreased Blood Pressure in the Legs (Answer C):
This is a hallmark sign of coarctation of the aorta. Due to the narrowing, blood flow to the lower extremities is significantly reduced, resulting in lower blood pressure in the legs compared to the arms. Often, there will also be a discrepancy in pulses, with weak or absent femoral pulses and stronger pulses in the upper extremities. The nurse should assess this carefully by comparing the pulses and blood pressures in all four limbs. - Hypertension in the Upper Extremities:
While blood pressure in the legs is reduced, the arms (especially the right arm) may show elevated blood pressure due to the increased resistance the heart faces while pumping through the narrowed aortic segment. - Cold or Pale Lower Extremities:
Due to reduced blood flow, infants may exhibit cooler or paler lower extremities compared to the upper body.
Other Options:
- A. Machine-like murmur:
This is a classic finding in a patent ductus arteriosus (PDA), not coarctation of the aorta. - B. Severe cyanosis:
Severe cyanosis is more typical of congenital heart defects that involve significant right-to-left shunting, like Tetralogy of Fallot, rather than CoA. - D. Pulmonary edema:
Pulmonary edema is not a primary manifestation of coarctation. While it can occur if heart failure develops, it is not one of the classic early signs.
In conclusion, infants with CoA typically present with reduced blood pressure in the lower extremities, often along with weak pulses in the legs and hypertension in the upper body. These findings are critical for diagnosis and assessment.