Abstract
A 30-year-old man presented to our clinic for evaluation of newly diagnosed hypertension. On examination, he had an apical systolic ejection click, a grade 2/6 systolic murmur, and weak femoral pulses. The difference in blood pressure between his arms and legs was 60 mm Hg. Echocardiography revealed coarctation of the aorta and a bicuspid aortic valve with mild stenosis. (See the Supplementary Appendix, available with the full text of this article at NEJM.org, for a chest radiograph showing the consequences of coarctation.) Catheterization through the right femoral artery was performed in preparation for stenting of the coarctation. Contrast material was injected . . .
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