What is Coarctation of the Aorta?

Coarctation of the aorta describes a narrowing of the aorta, which is the major artery carrying blood from the heart to the body. The congenital condition constricts blood flow from the heart to the lower part of the body.

About four out of every 10,000 babies born in the US have coarctation of the aorta. Babies born with this congenital heart defect are more likely to have other genetic disorders, such as Turner syndrome, and coarctation of the aorta might happen along with other congenital heart diseases, such as ventricular septal defect.

Infants with the defect can develop heart failure. In fact, about 50 percent of newborns with coarctation of the aorta will develop problems in the first several days after birth.

Children with milder cases might not experience symptoms until adolescence. Children who aren’t diagnosed in their infancy might develop symptoms including: chest pain, cold feet and legs, dizziness and fainting, low exercise tolerance, leg cramps during exercise, nosebleeds, poor growth, pounding headache, and shortness of breath. Occasionally there are no symptoms associated with coarctation of the aorta, although problems are likely to show up later in life.

Telltale signs during a physical exam include a weak pulse in the groin area (femoral pulse) compared to the pulse in the arm or neck or a harsh-sounding heart murmur. Older children who are found to have high blood pressure may also be evaluated for coarctation of the aorta.

If a pediatrician suspects coarctation of the aorta, specialized tests will be ordered to confirm the diagnosis, including a chest x-ray, echocardiogram, and possibly even a cardiac catheterization.

In order to correct this potentially serious defect, the aorta needs to be widened by surgery or catheterization. If the problem area is small, surgeons can perform an end-to-end anastomosis, a surgery that involves reconnecting the two ends of the aorta. When a large part of the aorta that is constricted, surgeons often use a man-made graft or the patient’s own tissue to fill the gap.

In some children, doctors can insert a balloon into the area and inflate the balloon to stretch and relieve the constriction. The procedure, called balloon angioplasty, is less invasive than surgery, but it has a higher failure rate.

Surgery can cure coarctation of the aorta. Without surgery, most people who have coarctation of the aorta die before age 40. However, children who have had procedures to fix their narrowed aortas might need to take medicine for high blood pressure for the rest of their lives. Often, blood pressure increases above the constriction and doesn’t return to normal levels, even after the surgery. Doctors will monitor children and adults who have had their aortas repaired because they are at higher risk for heart problems and death decades later.

Sources:

• U.S
• National Library of Medicine
• Coarctation of the aorta.
  American Heart Association
• Coarctation of the Aorta (CoA).
  Centers for Disease Control and Prevention
• Facts about Coarctation of the Aorta.

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