MEDizzy - A 12-year-old adolescent boy complaining from leg discomfort

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The Cardiovascular System II

A 12-year-old adolescent boy complaining from leg discomfort with exercise, headache, and frequent epistaxis. A continuous murmur heard throughout the chest and back. He was well with good body built but the blood pressure found to be high. Of the following, the BEST next action is to

ExplanationThe murmur of coaractation of aorta (COA) is typically best heard in the left interscapular area of the back. If significant collaterals have developed, continuous murmurs may be heard throughout the chest. For the above scenario the best next action is checking the pulse in all extremities and checking the 4 limbs blood pressure. Doing complete neurological assessment is also important but not the first choice. MRI of lumbosacral area to rule out tethered cord. After complete and proper physical examination sending for echocardiography and renal ultrasound will be next most appropriate action.