38. Choice D is the correct answer. Coarctation of the aorta is a narrowing of the aorta usually just below the left subclavian artery. Will produce a systolic murmur if murmur present. The fact that there is a significant elevation of the upper extremities compared to the lower extremities implies this is a late finding. Definitive treatment for this is surgery. This is not a normal finding. Blood pressure difference with a thoracic dissection is in the upper extremities in older patients.
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