Coarctation of the aorta is a narrowing of the aorta, the large blood vessel that delivers oxygen-rich blood throughout the body. Usually, the narrowing occurs near the ductus arteriosus, a blood vessel that was important in the fetus. This narrowing can cause increased blood pressure in your arms, and decreased blood pressure in your legs. The extra pressure in the heart can cause the heart muscle to thicken, which may cause it to weaken over time. If the narrowing is severe, symptoms are present in infancy. If it is not treated, heart failure or death can occur. Treatment for coarctation of the aorta often requires surgical repair.
Even after repair, patients with coarctation can develop high blood pressure or coronary artery problems at an earlier age than patients who have not had a coarctation. This may occur regardless of the amount of narrowing at the coarctation. Therefore, it is very important that patients who have had a coarctation repair have lifelong cardiology follow-up to monitor for any long-term complications.
Causes
Coarctation of the aorta is a congenital heart defect that occurs during fetal development or in the first week of life. In most cases, the cause is unknown.
Coarctation of the aorta symptoms
Symptoms vary depending on the degree of narrowing. Symptoms in infants include:
- Difficulty breathing
- Paleness
- Sweating
- Irritability
Sometimes the narrowing may be mild and the body will make new arteries around the narrowing. This may result in coarctation being diagnosed later in childhood or adulthood. The most common presenting symptom in older children or adults is high blood pressure.
Adolescents and adults who have the condition often do not have symptoms because their narrowing is usually less severe. If they do have symptoms, they may include:
- High blood pressure
- Muscle weakness
- Headaches
- Nosebleeds
- Shortness of breath
- Cold feet
- Leg cramps
Coarctation of the aorta may be detected by a physician who notices:
- High blood pressure in the arms
- A blood pressure difference between the arms and legs
- A heart murmur
- A weak pulse in the legs
Re-narrowing can occur without symptoms. If you had your condition repaired in childhood and narrowing has recurred, you may be a candidate for an additional cardiac catheterization procedure.
Treatments
Medications
Medication may be prescribed to help regulate blood pressure before surgery. It is not used to repair coarctation of the aorta.
Nonsurgical procedures
Balloon angioplasty and stenting are nonsurgical procedures to treat coarctation of the aorta.
Surgical procedures
Surgical procedures to treat coarctation of the aorta involve relieving the narrowing of the aorta to improve blood flow to the lower half of the body. This can be done by bypassing the narrowing, removing the narrowed segment and reattaching the aorta, or by making a patch from Gortex or another artery.