What feature distinguishes coarctation of the aorta on physical examination?

Discrepancy in blood pressure between the arms and legs is a key physical examination finding that is characteristic of coarctation of the aorta. In this congenital condition, the aorta is narrowed, typically just distal to the left subclavian artery, which can lead to differential blood flow. Because the upper body (arms) is supplied well by the aorta above the coarctation, the blood pressure in the arms is often elevated. Conversely, the lower body (legs) may experience significantly lower blood pressure due to reduced blood flow past the site of narrowing. This notable difference can be a critical clue in diagnosing coarctation and helps healthcare providers further assess the condition.

Other options do not specifically relate to the diagnosis of coarctation of the aorta in the same definitive manner. Regular heart rhythm, for instance, can be seen in many cardiovascular conditions and is not unique to coarctation. A holosystolic murmur could suggest other conditions such as mitral regurgitation and does not directly indicate aortic coarctation. Strong peripheral pulses might suggest adequate blood flow, but in the context of coarctation, pulses in the lower extremities may actually be weak due to reduced