wednesday's child

I see a small child this morning with the very unusual condition of coarctation of the aorta. In this, the baby is born with a pinching of the aorta, the principle vessel which emanates from the left ventricle of the heart and transmits oxygenated blood around the body. The pinching compromises the blood supply to the lower body, and if untreated usually leads to death in childhood. Fortunately, now an operation can entirely correct the problem, which is often diagnosed by the absence of femoral pulses in the infant.

The operation is coming soon, much to mum's relief, though she does mention the delays caused in reaching the diagnosis by almost everyone initially missing the fact that the femoral pulses were absent. I nod in agreement and check my notes. I examined the baby myself at the routine 8 week check, and passed it as normal. That is, I missed it too. I come clean, admitting that I appear to have missed it myself. She is not cross with me, but with the more expert paediatric cardiologists who also failed to spot it. Which fails to make me feel any better. I usually look for the femoral pulses very carefully, but I clearly failed this time. It doesn't make me feel good, I have to say.