Oscillometric blood pressures in the arm, thigh, and calf in healthy children and those with aortic coarctation.

Comparing blood pressure (BP) obtained in the arm with that obtained in the thigh or calf is important in the diagnosis of aortic coarctation. However, normative mean and range of differences in BP between the arm and lower extremity sites are not available for normal children. It is also not known how accurately the differences in BP between the arm and the lower extremity sites predict the pulsed Doppler estimation of systolic pressure (SP) gradient across an aortic coarctation. To resolve these questions, the authors obtained two BP measurements by an oscillometric (Dinamap) method in the arm, thigh, and calf in 74 healthy children aged 4 to 16 years. Oscillometric BP was also obtained in 21 children aged 3 to 17 years with preoperative or postoperative aortic coarctation and BP gradients were compared with that estimated by the pulsed Doppler method. Overall, SP was higher in the thigh and calf than in the arm. The gradients in SP expressed as arm SP minus calf SP [S(A-C)] and arm SP minus thigh SP [S(A-T)] were significantly greater in children 4 through 8 years old than in those 9 to 16 years old. The S(A-C) was -9.3 (+/- 7.4 SD) mm Hg in the 4- through 8-year group and -5.0 (+/- 6.9 SD) mm Hg in the 9- to 16-year group. The S(A-T) was -7.1 (+/- 6.8 SD) mm Hg in the 4- through 8-year group and -2.4 (+/- 7.7 SD) mm Hg in the 9- to 16-year group.(ABSTRACT TRUNCATED AT 250 WORDS)