Symptoms from coarctation depend on the severity of blood flow restriction. In severe cases, symptoms are present during infancy; in milder cases, symptoms may not develop until adolescence. Symptoms include decreased exercise performance, cold feet or legs, and shortness of breath. Other symptoms include:

• dizziness or fainting
• pounding headache
• nodding-like head movements accompanying heart beats
• nosebleed
• leg cramps with exercise
• hypertension (high blood pressure) with exercise

Note: There may be no symptoms.

An examination reveals high blood pressure in the arms and low blood pressure in the legs, with a significant blood pressure difference between the arms and legs. The femoral (groin) pulse is weaker than the carotid (neck) pulse, or the femoral pulse may be totally absent.

Listening to the heart through a stethoscope reveals a murmur that is harsh and can be heard in the back. There may be signs of left-sided heart failure (especially in infants) or signs of aortic regurgitation.

Coarctation is often discovered during a newborn infant's first examination or during a well-baby exam. The health care provider will detect that the femoral pulses are absent or very weak. Taking the pulses in an infant is an important part of the examination as there may not be any other symptoms or findings until the child is older.

Coarctation of the aorta can be confirmed by:

• X-ray of the chest (may also show abnormal ribs or "notching" of ribs caused by enlargement of the rib arteries)
• ECG that indicates left ventricle enlargement
• echocardiography
• Doppler ultrasound of the aorta
• chest CT
• MRI of the chest
• cardiac catheterization and aortography

Both Doppler ultrasound and cardiac catheterization can detect an aortic pressure gradient, that is, a difference in pressure within the aorta, caused by the coarctation.