8th March 2024

Clinical presentation

Most adults remain asymptomatic unless severe hypertension develops, which may lead to headaches and epistaxis. Lower limb claudication may also develop due to reduced blood flow. Typical findings on examination include hypertension of the upper limbs, diminished blood pressure of the lower limbs and radio-femoral delay. An ejection systolic murmur can be heard anteriorly or posteriorly. A continuous murmur in the left parasternal border may also be heard due to the presence of large collateral vessels.