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:
- 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.