A 41/2- year-old girl always had to wear warm socks even is summer season. On physical examination, it was noticed that she had high blood pressure and her femoral pulse was weak as compared to radial and carotid pulse, a chest radiograph showed remarkable notching of ribs along with their lower borders. This was due to
High-Yield Explanation
Headache, epistaxis, cold extremities, and claudication with exercise may occur Hea murmur or hypeension in the upper extremities and absence, marked diminution, or delayed pulsations in the femoral aeries are detected on physical examination. Enlarged and pulsatile collateral vessels may be palpated in the intercostal spaces anteriorly, in the axillae, or posteriorly in the interscapular area. The upper extremities and thorax may be more developed than the lower extremities. ( Harrison&;s principle of internal medicine,18th edition,pg no. 1925)