Could I Have an Aortic Coarcation?

Doctors, I have a strange situation.  I have blood pressure that differs greatly from arm to arm.  Usually, when I take my blood pressure at home my blood pressure in the left arm is low.  Typical would be 107/64 with pulse of 54.  My right arm on the other hand would show typically around 138/72 with 60 pulse.  My heart skips beats during some long periods.  When I am on blood pressure medicine my right arm blood pressure lowers almost to the same level as my left arm blood pressure.  Usually when I go to see my doctor, my blood pressure is even as I make sure that I am taking my blood pressure medicine before I see him.  When I mention the uneven blood pressure, he says don't worry about it.

I was diagnosed with a TIA stroke in August when I went to the emergency room with severe tingling and numbness of my left arm and leg, but all of the usual stroke tests were negative.  I had an ultrasound of my carotid artery, a cat scan and mri and everything looked fine.  .  They said I had a stroke anyhow.  When I arrived at the hospital, my left arm blood pressure which is usually the low one was up to 190/100.  My right arm blood pressure which is usually the higher one, was at 148/89.  They put me back on blood pressure medicine.  Lately, I have been feeling the numbness again.  Could they have missed a coartation?  I can't understand why my blood pressure is not close to even and why I keep having these problems with numbness and tingling on the left side.

[Mukesh Garg, MD]

Unequal blood pressure in the arms is usually due to some sort of blockage in the blood vessels, usually the large cetral blood vessels. Coarctation usually causes uneqal bllod pressure in the arms and legs. If all you tests found no blockage in your blood vessels and you did have a stroke, this could have been because of high blood pressure.