COARCTATION OF THE AORTA Negligence in Diagnosis Four (Case- Reports).

SUMMARY: Coarctation of the aorta is a congenital heart disease consisting 7% of total congenital heart diseases. Its prevalence in men is 2 times more than that in women. This disease is associated with other congenital diseases. including aortic bicuspid valve, the linkage between two ventricles and arteriole channel It is often seen in the Turner syndrome which may lead to complications such as cerebral hemorrhage, aorta discussion, aortic, rupture, and cerebrovascular aneurysm. Clinical manifestations appearing mostly in adults, are in the forms of headache, epistaxis, coldness of body organs, and limping at the time of activity The key and important diagnostic features for this disease are the losing or decrease of femoral pulsations along with the increase of blood pressure in the upper limbs. Thus, if patients or clients particularly the young people during cardio-vascular examinations have mid- systolic souffle in the anterior pectus segment with arterial hyper tension, the first guess is the coarctation of aorta. In this case, immediately the examination of pulse in the upper and lower limbs and then measurement of blood pressure in the limbs is done so that in the normal state, the blood pressure in the lower limbs is 15-20 mm Hg more than that in the upper limbs but in patients afflicted with the coarctation of the aorta, the difference of blood pressures between hands and feet is very high, and even sometimes blood pressure in the feet is not measurable. Furthermore, in the examination of pulses, femoral pulsation is weak or any in some cases. In the present article, all patients reported are afflicted with the coarctation of the aorta associated with arterial hypertension. The illness of these individuals whom must be diagnosed during neonatal and suckling periods (childhood ages), unfortunately due to the carelessness at the time of examinnation and negligence in diagnosis, the above mentioned disease is diagnosed with delay and in different ages of 11,22,24 and 36. The result is that the patients suffer heavy life and financial losses.