Infant with epistaxis and absent femoral pulses.

Coarctation of the aorta is a congenital cardiac abnormality that can lead to congestive heart failure in early infancy or can go undetected for many years. We discuss the case of an infant who presented to our emergency department with epistaxis and was found to have this lesion based on the physical examination. The identification of this lesion before the onset of symptoms leads to improved survival in these patients. A cardiac murmur and differential blood pressure between upper and lower extremities are the most reliable physical findings for identifying patients with coarctation of the aorta. Absent femoral pulses are a hallmark of this lesion, but not a dependable finding.