What physical exam finding is highly indicative of coarctation of the aorta in a 14-year-old patient?

Delayed femoral pulse when compared to the brachial pulse is a key physical exam finding that indicates coarctation of the aorta. This condition involves a narrowing of the aorta, typically just distal to the left subclavian artery, which can impede blood flow to the lower body while allowing normal or increased blood flow to the upper body.

In practice, when a healthcare provider palpates the brachial pulse in the arms and then the femoral pulse in the legs, they may notice that the femoral pulse is delayed. This finding is due to the obstruction caused by the narrowed section of the aorta, which causes a lag in the pulse wave reaching the lower extremities. Consequently, there is a discrepancy between the pulses of the upper and lower bodies, which is highly suggestive of coarctation.

The other options do not specifically indicate coarctation as clearly. Weak pulses in the upper extremities could be related to other conditions that affect circulation, bounding pulses in the lower extremities usually suggest other issues, such as aortic regurgitation, and a characteristic heart murmur does not directly correlate with coarctation alone as murmurs can suggest various cardiac abnormalities. Therefore, the presence of a