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A 6-year-old African girl was admitted with heart failure, tachycardia with gallop rhythm and hepatomegaly. Peripheral pulse examination showed absence of the right brachial and carotid pulses, but femorals were palpable; and right carotid and paraumbilical systolic murmurs were noted. Four limbs’ blood pressure discrepancy was present (right arm 100/70 mm Hg, left arm 141/87 mm Hg, right leg 123/82 mm Hg, left leg 117/76 mm Hg). Echocardiography showed left atrial and ventricular dilatation and severe dysfunction, with normal aortic arch but abdominal coarctation. CT angiography showed occlusion of the brachiocephalic trunk, and the right subclavian artery, as well as stenosis of the right common carotid artery, and abdominal coarctation at …
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