Question

The physician has ordered blood pressures and pulses to be taken in all four extremities of a six-month old admitted with a congenital heart defect. Which congenital heart defect is associated with elevated blood pressures and bounding pulses in the upper extremities, but low blood pressures and faint pulses in the lower extremities: A. Ventricular septal defect B. Coarctation of the aorta C. Transposition of the great vessels D. Patent ductus arteriosus

Short answer

Answer: B. Coarctation of the aorta

Step-by-step solution

Ventricular septal defect

Ventricular septal defect (VSD) is a hole in the wall separating the two lower chambers of the heart. This condition can cause a mixing of oxygenated and deoxygenated blood but does not typically cause differences in blood pressure and pulses between the upper and lower extremities. So, this option is not the correct answer.

Coarctation of the aorta

Coarctation of the aorta is a narrowing of the aorta, which is the main blood vessel carrying oxygen-rich blood from the heart to the rest of the body. The narrowing may cause differences in blood pressure and pulse between the upper and lower extremities, as it restricts blood flow to the lower extremities, resulting in elevated blood pressure and bounding pulses in the upper extremities, and low blood pressure and faint pulses in the lower extremities. This condition matches the given scenario.

Transposition of the great vessels

Transposition of the great vessels is a condition where the pulmonary artery and the aorta are switched (connected to the wrong ventricles). This condition causes a mixing of oxygenated and deoxygenated blood but does not lead to differences in blood pressure and pulses between the upper and lower extremities. Hence, this option is not the correct answer.

Patent ductus arteriosus

Patent ductus arteriosus (PDA) is a persistent opening between the aorta and the pulmonary artery, which are the two major blood vessels leading from the heart. While PDA can cause some issues in circulation, it does not generally cause differences in blood pressure and pulses between the upper and lower extremities. Therefore, this option is not the correct answer.

Select the correct option

After analyzing all the given options, we can conclude that the congenital heart defect associated with elevated blood pressures and bounding pulses in the upper extremities, but low blood pressures and faint pulses in the lower extremities is: B. Coarctation of the aorta