RT Book, Section A1 Krieger, Eric V. A1 Stout, Karen K. A2 Daniels, Curt J. A2 Zaidi, Ali N. SR Print(0) ID 1128633745 T1 THE ADULT WITH COARCTATION OF THE AORTA T2 Color Atlas and Synopsis of Adult Congenital Heart Disease YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071749435 LK accesscardiology.mhmedical.com/content.aspx?aid=1128633745 RD 2024/03/28 AB A 23-year-old man was seen for difficult-to-control hypertension. On initial presentation he had a blood pressure (BP) of 160/90 mm Hg. Despite initiation of multiple antihypertensive medications including hydrochlorothiazide and lisinopril, the patient remained hypertensive with systolic BP of greater than 140 mm Hg. The patient was asymptomatic but reported a lifelong murmur. Physical examination revealed a right upper extremity BP of 146/82 mm Hg. Cardiovascular examination was significant for a grade II/VI systolic ejection murmur and a posterior systolic murmur in the left infrascapular region. Lower extremity pulses were diminished. A transthoracic echocardiogram demonstrated a bicuspid aortic valve, mild aortic dilation, and flow acceleration across the aortic isthmus.