What condition should be suspected in a child presenting with hypertension?

In a pediatric patient presenting with hypertension, coarctation of the aorta should be suspected due to its characteristic presentation and the typical demographic it affects. Coarctation of the aorta is a congenital narrowing of the aorta, usually occurring just distal to the left subclavian artery. This condition can lead to significant differences in blood pressure readings between the upper and lower extremities. In children with coarctation, the upper body often has higher blood pressure compared to the lower body, which can present with systemic hypertension.

The identification of coarctation is crucial as it can lead to secondary complications, such as heart failure or aortic rupture, if left untreated. The condition often presents with other clinical manifestations such as diminished or absent femoral pulses, which can help clinicians distinguish it from other causes of hypertension.

Other conditions listed, such as cardiomyopathy, aortic stenosis, and congenital heart failure, may also lead to hypertension but are less common as an isolated cause in the clinical scenario described. Cardiomyopathy usually presents with symptoms of heart failure rather than primary hypertension alone. Aortic stenosis can increase blood pressure but is often associated with other characteristic symptoms and physical exam findings. Congenital heart failure,