Overview, Causes, & Risk Factors
The aorta is the main artery of the body and carries blood awayfrom the heart. Coarctation is an abnormal narrowing in theaorta that is present at birth, causing congenital heart disease.
What is going on in the body?
It is not known why coarctation of the aorta occurs. Thenarrowing in the aorta decreases the amount of blood that can flow through it.The worse the narrowing, the worse the symptoms. Severe cases may lead toearly symptoms in infancy. Milder cases may not be discovered until adulthood.
What are the causes and risks of the condition?
The cause of coarctation of the aorta is unknown. Those whoare at higher risk for this condition include:
Symptoms & Signs
What are the signs and symptoms of the condition?
Symptoms of coarctation of the aorta may be mild or severe.In severe cases, symptoms usually begin shortly after birth. The main symptomsare due to congestive heart failure,as the heart cannot pump blood through the narrowed passage. Congestive heart failurein children can cause:
If symptoms do not occur until later in life, they may include:
Most of these symptoms tend to get worse with exercise. Theyare mostly due to the fact that blood can flow more easily to the upper body,which is above the narrowed portion of the aorta. The lower body, which is belowthe narrowed section of aorta, does not get as good a blood supply, so it doesnot grow as well.
Diagnosis & Tests
How is the condition diagnosed?
The diagnosis of coarctation of the aorta may be suspectedfrom the medical history and physical exam. A heart tracing, called anEKG,and a chest X-rayare commonly done and may be abnormal. Imaging tests of the heart,such as a test that uses sound waves called echocardiography,can confirm the diagnosis. A chest MRIand chest CT scancan also show the defect.
An X-ray procedure called cardiac catheterizationmay be done in some cases. In this test, a thin tube is inserted through theskin and into an artery, usually in the groin. The tube is then advanced alongthe artery and up into the heart. A contrast agent can then be squirted throughthe tube and into the blood. X-ray pictures of the contrast agent can be takenas it flows through the heart and aorta.
Prevention & Expectations
What can be done to prevent the condition?
There are no known ways to prevent coarctation of the aorta.
What are the long-term effects of the condition?
In severe cases, newborns with coarctation of the aorta can diewithout immediate treatment. Long-term effects include:
Adults rarely survive past the age of 40 without treatmentbecause of these long-term effects. Timely treatment can avoid most ofthese effects.
What are the risks to others?
Coarctation of the aorta is not catching and poses no risksto others.
Treatment & Monitoring
What are the treatments for the condition?
Severely affected infants with coarctation of the aorta may needsurgery shortly after birth. Before surgery, these infants may need aggressivetreatment in the intensive care unit.This may include powerful medicines and an artificial breathing machine called aventilator.
For those with no symptoms at birth, surgery is often advisedlater in childhood or in early adulthood when symptoms or heart damage begin.The goal of surgery is to remove or bypass the narrowed part of the aorta.
What are the side effects of the treatments?
Surgery carries a risk of bleeding, infections,allergic reactionsto anesthesia,and even death.
What happens after treatment for the condition?
After recovering from surgery, most people do well. Long-termfollow-up care is needed to watch for or treat high blood pressure,which is fairly common after surgery. Narrowing in the aorta can recur,especially in children less than 5 years old. In the absence of high bloodpressure, most people can resume a normal life after recovery.
How is the condition monitored?
Long-term monitoring of blood pressureis needed. Other monitoring may be needed if heart damage or other heartdefects are present before surgery. Any new or worsening symptoms shouldbe reported to the doctor.
Article type: xmedgeneral