What is aortic coarctation?
Aortic coarctation is also known as narrowing of the aorta. It is a constriction of the aorta, the large blood vessel that branches off from the heart and supplies the body with oxygen-rich blood.
When this constriction occurs, the heart must pump harder to push blood through the narrowed part of the aorta.
Aortic coarctation is usually congenital (appears at birth).
Prognosis of the disease
In many cases, the pathology is not detected until adulthood. The severity of the prognosis can vary widely and depends on the level of narrowing of the aorta.
Usually, this coarctation of the aorta is accompanied by other cardiac defects. Most patients have an optimal prognosis but regular follow-up is important.
In infants, untreated aortic coarctation may lead to heart failure or even death.
Symptoms of aortic coarctation
In many cases the condition is asymptomatic but it will depend on the severity of the disease. For example, children with severe narrowing are likely to show signs at an earlier age but these may not be diagnosed until adulthood.
Infants with severe aortic coarctation may show symptoms and signs soon after birth. Some of these include:
- Pale skin
- Heavy sweating
- Irritability
- Difficulty feeding and breathing
Older children and adults usually do not have symptoms, as the narrowing is usually less severe. When symptoms appear after childhood, the patient most likely has hypertension (high blood pressure) in the arms. Some of the symptoms that can be detected are:
- High blood pressure
- Muscle weakness
- Headache
- Nosebleeds
- Chest pain
- Leg cramps
High blood pressure may be a symptom of aortic coarctation.
Medical tests for aortic coarctation
The specialist will perform a physical examination of the patient and check the patient’s blood pressure and pulse in the legs and arms. There are different tests that may be performed:
- Echocardiogram
- Chest x-ray
- Electrocardiogram
- Magnetic resonance imaging
- Computed tomography
- Cardiac catheterization
What are the causes of aortic coarctation?
The cause of coarctation of the aorta is unknown. The condition results from abnormalities in the development of the aorta before birth.
It is very rare later in life, although traumatic injury may eventually cause coarctation of the aorta. On other rare occasions, severe hardening of the arteries or inflammation can trigger the pathology.
Can it be prevented?
It is not possible to prevent aortic coarctation because, generally speaking, it is present at birth.
However, it is possible to assess different conditions that may help in early detection. Some of the factors that may increase the risk of aortic coarctation include:
- Turner syndrome
- Bicuspid or similar aortic valve
- Family history of congenital heart disease
Treatments for aortic coarctation
Treatment will depend on the age of the patient at the time of diagnosis and the severity of the pathology. In some cases other heart defects are corrected at the same time.
Treatments are usually based on surgery or balloon angioplasty. The specialist will assess the best option for each case.
- Surgery: during surgery, the narrowed part of the aorta is opened or removed. There are various surgical techniques, such as resection with end-to-end anastomosis or bypass graft repair.
- Balloon angioplasty and stenting: this is an option for initial treatment or for cases of re-narrowing after surgery.
In the case of newborns, surgery is performed shortly after birth, although they will initially receive medication to stabilize them. Older children also need surgery and usually need treatment for high blood pressure.
What specialist treats it?
Aortic coarctation should be treated by a specialist in pediatric cardiology.