Which finding best supports a diagnosis of coarctation of the aorta?

• A. Bounding femoral pulses
• B. Weak femoral pulses compared to the brachial pulses
• C. Normal pulses in all extremities
• D. Absent pulses in all extremities

Answer: (B)

Coarctation of the aorta causes reduced blood flow to the lower body while the upper body remains relatively normal or even hypertensive. This creates a noticeable difference between the pulses in the legs and those in the arms. The strongest clue is when femoral pulses are weak compared with brachial pulses, often with a radiofemoral delay and higher blood pressure in the arms than the legs.

A bounding femoral pulse would suggest a different issue such as a high-output state or aortic regurgitation. Normal pulses in all extremities fit less with a localized aortic narrowing, and absent pulses in all extremities would imply a much broader, more acute vascular problem not typical of isolated coarctation.