• Higher risk of PE, post-thrombotic syndrome
• If low risk for bleed with an acute clot, consider catheter directed thrombolysis
• Consult vascular surgery and consider transfer if at an outside community ED
Coarctation of the Aorta
• Physical exam findings include:
- Signs of heart failure including respiratory distress, wet lungs, hepatomegaly
- Diminished pulses of lower extremities
• When seeing an infant in shock, THINK SEPSIS and remember your resuscitation pathways, but don't forget about the heart.
- Giving a dose of prostaglandin E will help you more often than hurt you
- Give fluids judiciously; give a bolus and reassess.
• Bedside echo can help you in extremes of cardiac function, but otherwise murky.