Borderline and Hypertension

Abstract

An asymptomatic 17-year-old undocumented male immigrant was noted to have severe hypertension during immigration intake. Identification of a gradient between the upper and lower extremities and the radial- emoral pulse delay led to extensive workup culminating in a diagnosis of interrupted aortic arch and ventricular septal defect. Medical and surgical management resolved thepatient’s hypertension but was accompanied by profound congestive heart failure. On discharge, his functional status had improved markedly.