If a patient has higher blood pressure in the right arm than the left arm, what condition might they have?

When a patient presents with higher blood pressure in one arm compared to the other, it raises suspicion for coarctation of the aorta. This condition involves a narrowing of the aorta, which can lead to differential blood pressure readings between the upper and lower parts of the body. In the case of a coarctation located distal to the branches supplying the arms, the right arm may exhibit higher blood pressure than the left as it receives blood supply directly from the aorta above the point of coarctation, while the left arm may be affected by the narrowing and thus have lower pressures.

The presence of this gradient in blood pressure is a key clinical indicator that aids in the diagnosis of coarctation of the aorta, making it critical for healthcare providers to evaluate blood pressure in both arms during examinations. This condition can also be associated with other findings such as differential pulses and may lead to further complications if not addressed.

Other conditions listed, such as myocardial infarction, atrial septal defect, and heart failure, do not typically present with such a pronounced difference in blood pressure between the arms, making them less likely explanations for the situation described. Therefore, the elevation of blood pressure in the right arm compared to the left strongly