Secondary hypertension in a migrant farm worker: a case report of coarctation of the aorta.

PURPOSE: To report a case of undetected aortic coarctation in an adult Hispanic migrant farm worker that presented with uncontrolled hypertension and transient left flank pain. A primary care overview of the disorder, clinical diagnosis, testing, and treatment are discussed. DATA SOURCES: Case report, scientific literature, diagnostic evidence. CONCLUSIONS: Coarctation of the aorta is a significant congenital cardiovascular anomaly and cause of secondary hypertension. The majority of patients with coarctation of the aorta are diagnosed during infancy. Older children and adults may have a subtle presentation, but can be identified as being at risk by having a thorough history and physical, as well as noninvasive diagnostic testing. IMPLICATIONS FOR PRACTICE: Primary care providers must have a high degree of suspicion in patients with risk factors or in individuals that may have not benefited from adequate health screening. Early diagnosis and correction of the coarctation is important to reduce persistent postoperative hypertension and improve long-term survival.