A case of blurred vision due to coarctation of the aorta, an early clinical presentation, or just a coincidence?

Rationale: Coarctation of the aorta (CoA) is frequently misdiagnosed as primary hypertension. This is the first reported pediatric case of CoA presenting with both hypertension and blurred vision, highlighting an underrecognized diagnostic red flag. Patient concerns: An 8-year-old boy had blurred vision for 2 years and complained of “myopia,” admitted to the Department of Cardiology for “elevated blood pressure on physical examination for 2 days.” Diagnoses: Computed tomography angiography examination suggested CoA, which was confirmed by surgical and pathologic examination. Interventions: The cardiothoracic surgeon performed aortic arch angioplasty, aortic aneurysm resection, and anastomosis. Outcomes: Postoperatively, the child underwent pharmacologic antihypertensive and anticoagulant therapy. Six months later, his blood pressure was normal, and all medications were discontinued. Lessons: Blurred vision in children may signal hypertensive retinopathy from secondary causes like CoA. Early cardiovascular evaluation is critical to prevent irreversible end-organ damage.