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Cardiovascular System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This lady has presented with exertional dyspnea and fatigue - non specific symptoms which may be caused by a myriad of diseases.\n\nHer examination is considerably more fruitful, revealing significant hypertension associated with radio-femoral delay and an ejection systolic murmur radiating to the inter-scapular region. These findings are almost diagnostic of coarctation of the aorta.\n\nAn important clinical point is that the blood pressures of the upper and lower limbs should be compared in patients with suspected aortic coarctation. A pressure difference of \u003E 20 mmHg in favor of the upper limbs is virtually pathognomonic of coarctation (note that in normal individuals, the blood pressures of the lower limbs are higher than those of the upper"}]}

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