Coarctation
of the Aorta
What is Coarctation of the Aorta?
Coarctation of the Aorta is a constriction in the aorta
causing obstruction to blood flow. The narrowing most often
is located just after the aorta gives its branches to the
head and arms as it curves down to supply the lower body.
The left ventricle of the heart has to work harder to force
blood past the narrowed area. This may cause the left ventricle
to weaken and may cause an elevation of blood pressure before
the narrowed area.
What are the warning signs and symptoms of Coarctation
of the Aorta?
Coarctation of the Aorta generally presents in one of two
ways:
- An infant, often in the second week
of life, may not tolerate the obstruction and may develop
signs of significant congestive heart failure including
labored breathing, poor feeding, and decreased urination.
- Some infants, however, tolerate the obstruction very well
and their hearts rapidly compensate. The diagnosis is then
often made later in life, either in childhood or adulthood,
and the person may be referred to a specialist because of
the presence of a heart murmur or elevated blood pressure
in the upper extremities.
How is Coarctation of the Aorta detected?
Coarctation of the Aorta may be suspected because of the
following:
- A heart murmur
- Elevated blood pressure in the upper
extremities with lower blood pressure in the lower
extremities
- Absent pulses in the lower extremities
The following tests can confirm the presence of the Coarctation:
- Echocardiography
- MRI Scan
- CT Scan
- Cardiac Catheterization
What are the treatment options for Coarctation of
the Aorta?
The treatment of Coarctation of the Aorta for many years
has been surgical repair. This is still the treatment of choice
in infants. Infants presenting with symptoms require surgical
correction. In older children and adults, a newer non-surgical
approach can be offered. A catheter is threaded from the artery
in the groin up to the area of narrowing. The catheter has
a balloon on the end of it and when the narrowed area is straddled,
the balloon is inflated to expand the area (see Balloon Angioplasty).
Sometimes a metallic stent is placed over the balloon. When
the balloon is inflated, the stent enlarges along with the
balloon to open up the narrowed area. When the balloon is
then deflated and removed, the metal stent retains its enlarged
shape and keeps the artery open.
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