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May 1, 1954


JAMA. 1954;155(1):36. doi:10.1001/jama.1954.73690190004012a

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This patient lived a little longer than the 32-year average for one suffering from aortic coarctation. He died of cardiac failure secondary to the long-standing hypertension. The other common causes of death in coarctation are cerebral thrombosis or hemorrhage, bacterial endocarditis at the site of narrowing, or aortic rupture. This congenital lesion is of greater interest now to the clinician because of its susceptibility to surgical correction even when discovered in the third or fourth decade. The degree of coarctation may vary from very slight to extreme constriction. The clinical signs may be absent or striking according to the degree to which the collateral vessels are forced to enlarge to compensate for the constriction. Although hypertension may not be present in the upper extremities, it usually is a leading sign. The pulses in the lower extremities will be found to be very weak and the blood pressure diminished. Other suggestive

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