Missed Minutes Can Mean Millions...

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Coarctation of the aorta is a congenital narrowing of the aorta, leading to obstruction of blood flow from the heart to the lower body. 

It may present in infancy or childhood and can be life-threatening if unrecognized. 

Common findings include upper extremity hypertension, weak femoral pulses, and differential blood pressures. 

Diagnosis is made through echocardiography (or MRI in older children and adolescents), with surgical repair or balloon angioplasty as treatment options.

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I had a 2 week old patient three years ago who was hypothermic. 

His rectal temp was 95 degrees Fahrenheit and he looked gray. 

I sent him to the pediatric ED and he was sent home after about an hour with an initial temp of 97. 

I called the parents and told them to take him back if anything changes, including refusal to eat. 

My patient was diagnosed with coarctation of the aorta after dad took him back to the ED for feeding refusal. 

He had his emergency surgery and was on a vent for over a week. 

Luckily, he did well and just recently had his third birthday. 

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Legal Nurse Consultants play a critical role in identifying deviations from standards of care in cases involving coarctation of the aorta. 

Potential litigation areas include failure to diagnose, improper management, surgical complications, and inadequate follow-up. 

LNCs evaluate medical records by reviewing vital signs and any discrepancies, provider actions, documentation quality, and adherence to pediatric cardiology guidelines.

LNCs determine if complications were recognized and managed promptly.

Coarctation of the aorta cases require thorough review of diagnostic accuracy, timeliness of intervention, and documentation integrity. LNCs bridge clinical insight and legal strategy by identifying where standards of care were met or breached. 

Even after repair, patients require lifelong follow-up due to risk of hypertension and re-narrowing.