Description

Aortic coarctation (ko-ahrk-TAY-shun) is a narrowing of part of the body's main artery, called the aorta. The condition forces the heart to work harder to pump blood.

Coarctation of the aorta is usually present at birth. That means that it is a congenital defect of the heart. But sometimes, the condition can occur later in life.

Coarctation of the aorta often occurs in conjunction with other congenital heart defects. The treatment to correct the condition is usually successful. But regular health checkups are necessary for life, to observe the changes in the health of the heart.

Symptoms

Symptoms of coarctation of the aorta depend on the amount of the aorta is reduced. Most of the people do not have symptoms.

Adults and older children with a mild degree of coarctation of the aorta may have no symptoms and their hearts may seem healthy.

If a baby is born with an extreme narrowing of the aorta, symptoms may be noticed shortly after his birth. Symptoms of coarctation of the aorta in infants include:

  • Difficulty breathing.
  • Difficulty feeding.
  • Excessive sweating.
  • Irritability.
  • Changes in the color of the skin.

Symptoms of coarctation of the aorta later in life may include:

  • Pain in the chest.
  • The high blood pressure.
  • Headaches.
  • The muscle weakness.
  • Cramps in the legs.
  • Cold feet.
  • Nosebleeds.

Coarctation of the aorta often occurs with other diseases of the heart present at birth. Other symptoms depend on the specific types of congenital heart defects.

When to see a doctor

Get medical help right away for any pain in the chest that is extreme or cannot be explained.

Also get medical help for these symptoms:

  • Fainting.
  • Sudden shortness of breath.
  • The high blood pressure that can not be explained.

These symptoms can be caused by many health conditions. A complete health checkup is necessary to know the cause.

Causes

The cause of the coarctation of the aorta is clear. It is usually a problem of the heart that are present at birth is called a congenital defect of the heart. A congenital defect of the heart that occurs as the baby grows in the womb during pregnancy. The cause is often unknown.

Rarely, coarctation of the aorta may occur later in life. Conditions or events that may be close to the aorta and the cause of this disease include:

  • The traumatic injury.
  • At one end of the accumulation of cholesterol and fats in the arteries, called atherosclerosis.
  • A rare type of inflammation and irritation of the blood vessels in the heart, called takayasu's arteritis.

Risk factors

Risk factors for coarctation of the aorta include:

  • The male sex.
  • Some genetic diseases, such as Turner syndrome.
  • Some diseases of the heart present at birth, called congenital heart defects.

Congenital heart defects associated with coarctation of the aorta include:

  • The bicuspid aortic valve. The aortic valve is between the main artery of the body and the lower left chamber of the heart. If the aortic valve has only two flaps, called cusps, instead of the usual three, called a bicuspid valves.
  • Aortic stenosis. This is a narrowing of the area below the aortic valve. It blocks the flow of blood from the lower left chamber of the heart to the aorta.
  • Patent ductus arteriosus. The ductus arteriosus is a blood vessel that connects the left pulmonary artery to the aorta. When a baby is growing in the womb, this vessel allows blood to go around the lungs. Shortly after his birth, the ductus arteriosus usually closes. If it stays open, the opening is called a patent ductus arteriosus.
  • Holes in the heart. Some people with coarctation of the aorta are also born with a hole in the heart. If the hole is between the upper chambers of the heart, it is called an atrial septal defect. A hole between the heart's lower chambers is called a ventricular septal defect.
  • Congenital stenosis of the mitral valve. This is a type of heart valve disease that some people are born with. The valve that is located between the upper and lower left chambers of the heart close. It is hard for blood to move through the valve.

Complications

The complications of coarctation of the aorta happen due to the lower left chamber of the heart has to work harder to pump blood through the narrowed artery. This makes the blood pressure go up in the lower left part of the heart of the camera. In addition, the wall of the chamber can get thick. This condition is called left ventricular hypertrophy.

The complications of coarctation of the aorta include:

  • Long-term high blood pressure. The blood pressure decreases after the surgery to repair the aorta. But you can still be higher than usual.
  • A weakened or dilatation of the artery in the brain, also known as a brain aneurysm.
  • Bleeding in the brain.
  • A rupture or tear in the main artery of the body, called aortic dissection.
  • A bulge in the wall of the main artery of the body, called an aneurysm of the aorta.
  • Disease of the coronary artery.
  • Stroke.

Timely treatment is necessary to help prevent the complications. Without treatment, the coarctation of the aorta may lead to:

  • The renal failure.
  • Heart failure.
  • Death.

Some people have complications after the treatment of coarctation of the aorta. These complications include:

  • Re-narrowing of the aorta, called re-coarctation.
  • Aneurysm of the aorta or of the rupture.

To avoid complications, people with coarctation of the aorta need of regular health examinations for life.

Prevention

There is No known way to prevent the coarctation of the aorta. Tell your healthcare team if you have a family history of heart disease present at birth.

Diagnosis

The diagnosis of aortic coarctation may depend on the severe form of cardiovascular disease. Aortic coarctation is severe is generally diagnosed shortly after birth. The condition can be seen in the ultrasound images taken during pregnancy.

If the condition is mild, it may not be found until later in life.

To diagnose aortic coarctation, a health care professional checks the blood pressure in the arms and legs. Depending on the part of the aorta is affected, blood pressure can be elevated in the arms and lower legs and ankles. The pulse may be weak or delayed on the legs.

A whooshing sound called a heart murmur can be heard when listening with the heart.

Tests

Tests are done to diagnose coarctation of the aorta.

  • The echocardiogram. Use sound waves to create images of the beating heart. An echocardiogram shows how blood flows through the heart. The test can often tell you which part and how much of the aorta is reduced. An echocardiogram also helps the professionals of the health plan of treatment of coarctation of the aorta.
  • Electrocardiogram (ECG or EKG). This quick and painless test checks the heartbeat. Sensors called electrodes stick in the chest and sometimes the arms or legs. Connect the cables from the sensors to a machine, which displays or prints the results. If the aorta is very small, an ECG may show a thickening of the walls of the lower chambers of the heart.
  • X-ray of the chest. An x-ray of the chest shows the condition of the heart and the lungs. A chest x-ray may show a narrowing of the aorta at the site of the coarctation.
  • Cardiac magnetic resonance imaging (MRI). This test uses magnetic fields and radio waves to create detailed images of the heart and blood vessels. It can be shown that part and how much of the aorta is reduced. A health professional can also use the mri results to guide treatment.
  • Computed tomography (CT scan). A ct scan uses a series of X-rays to create detailed cross-sectional images of the body.
  • Coronary angiography with cardiac catheterization.A coronary angiogram uses X-rays to look at the blood vessels of the heart, called coronary arteries. Usually it is done to see if a blood vessel is narrowed or blocked. Coronary angiography is part of a general group of tests of the heart and the so-called treatments of cardiac catheterization. During cardiac catheterization, a thin, flexible tube called a catheter is placed in a blood vessel, usually in the groin or the wrist, and guided to the heart. Contrast dye flows through the catheter into the arteries in the heart. The dye makes the arteries more easily seen on X-ray images and video. Cardiac catheterization can help determine how much of the aorta is reduced.
  • Computed tomography angiography. This test looks at the arteries that supply blood to the heart. Used a powerful X-ray machine to produce images of the heart and its blood vessels. A computed tomography angiography uses a dye and special X-rays to show how blood flows through the veins and arteries. The test can show the location and severity of the coarctation of the aorta. You can also tell if the other blood vessels affected. A computed tomography angiography can also be used to guide the treatment.

Coronary angiography with cardiac catheterization. A coronary angiogram uses X-rays to look at the blood vessels of the heart, called coronary arteries. Usually it is done to see if a blood vessel is narrowed or blocked. Coronary angiography is part of a general group of tests of the heart and the so-called treatments of cardiac catheterization.

During cardiac catheterization, a thin, flexible tube called a catheter is placed in a blood vessel, usually in the groin or the wrist, and guided to the heart. Contrast dye flows through the catheter into the arteries in the heart. The dye makes the arteries more easily seen on X-ray images and video. Cardiac catheterization can help determine how much of the aorta is reduced.

Treatment

The treatment of coarctation of the aorta depends on the age of the person is when the heart condition is diagnosed. The treatment also depends on the amount of the aorta is reduced.

Coarctation of the aorta, the treatment may include:

  • Drugs.
  • A heart operation.
  • Surgery.

If there is other birth defects of the heart, which can be repaired in the same time.

Medicine

Drugs for aortic coarctation may include:

  • Blood pressure medications. The drugs are used for the control of blood pressure before surgery to repair it. Although fixation of the aorta may improve blood pressure, many people still need blood pressure medications after the surgery repair.
  • Medicine to keep the ductus arteriosus open. Babies are born with a temporary opening, called the ductus arteriosus, between the aorta and the pulmonary artery. This opening allows part of the blood that goes to the lungs. The ductus arteriosus is most often closes shortly after birth. But the medication can keep it open. Infants with severe coarctation of the aorta often to get the medication until surgery is performed to repair the aorta.

Surgery or other procedures

Heart surgery or any other procedure that can be done for the repair of aortic coarctation. The options include:

  • Balloon angioplasty and stent placement.This may be the first treatment of aortic coarctation. Sometimes if the aorta is narrow again after coarctation surgery. The treatment helps to widen a narrowed artery and improve the blood flow. During the angioplasty procedure, a doctor uses a thin tube, called a catheter, and a small balloon to open a narrowed artery. Usually, a small metal coil called a stent is placed in the artery. The stent keeps the artery open. It also reduces the risk of renarrowing.
  • Resection with end-to-end anastomosis. A surgeon removes the narrow area of the aorta. This is called a resection. The surgeon then connects the two healthy parts of the aorta. This is called anastomosis.
  • Flap subclavian aortoplasty. A surgeon takes the part of the blood vessel that carries blood to the left arm, called the left subclavian artery, and is used to expand the narrow area of the aorta.
  • Bypass graft repair. This surgery uses a tube called a graft to create a new path for blood to flow around the narrow part of the aorta.
  • Patch aortoplasty. The surgeon cuts through the narrow area of the aorta and patches on a piece of material to expand the blood vessels. This treatment is useful if the coarctation involves a long part of the aorta.

Balloon angioplasty and stent placement. This may be the first treatment of aortic coarctation. Sometimes if the aorta is narrow again after coarctation surgery. The treatment helps to widen a narrowed artery and improve the blood flow.

During the angioplasty procedure, a doctor uses a thin tube, called a catheter, and a small balloon to open a narrowed artery. Usually, a small metal coil called a stent is placed in the artery. The stent keeps the artery open. It also reduces the risk of renarrowing.

After the repair, aortic surgery, health examinations are required for life, to keep a track of your blood pressure and watch for complications.

Lifestyle and home remedies

The people who had coarctation of the aorta and the need to take measures to control blood pressure and watch for complications. Follow these tips:

  • Get regular exercise. Regular exercise helps to lower blood pressure. Talk with your health care team about the amount and type of exercise is best for you. Some physical activities, such as weightlifting, you can temporarily increase the blood pressure.
  • Talk with your health care team before you get pregnant. Coarctation of the aorta, even after it is fixed, can increase the risk of a tear or rupture of the aorta during pregnancy and childbirth. Before becoming pregnant, discuss with a doctor trained in congenital heart disease, called to an adult congenital cardiologist. Together, you can go on the potential risks and complications.
  • Prevent infections of the heart. The bacteria can affect the inner lining of the heart or of the valves, causing an infection called endocarditis. People with certain disorders of the heart may need to take antibiotics before dental work to prevent infection. Ask your health care professional if you need preventive antibiotics.

Preparing for your appointment

If the coarctation of the aorta is diagnosed at birth, there is no time to prepare. If the symptoms are not noticed until later in life, see a doctor trained in heart problems present from birth. This type of health care provider that is called a congenital cardiologist.

Here's some information to help you prepare for the appointment.

What you can do

Note the following, and bring the notes with you to your appointment:

  • Any of the symptoms, including any that may seem unrelated to the coarctation of the aorta. Note when each of the symptoms began.
  • Important medical information, including any family history of heart problems present from birth.
  • All medications, vitamins and supplements taken during pregnancy or current. Include the dose.
  • Any questions you want to ask your health care professional.

Questions for the health care professional include:

  • How is coarctation of the aorta is it about?
  • What treatment do you recommend and why?
  • What will be involved in the recovery and rehabilitation after surgery?
  • What is the frequency of the follow-up of tests and exams necessary?
  • What is the risk of the complications of this condition?
  • What symptoms or warning signs should I watch out for in the home?
  • What is the long-term prognosis?
  • You recommended the diet, the exercise or sport of restrictions?
  • Antibiotics are necessary before dental work, or other medical procedures?
  • Is pregnancy safe for people with coarctation of the aorta?
  • What is the risk that my or my child in the future the children will have coarctation of the aorta?

Do not hesitate to ask any other questions.

Also ask someone to go with you to the appointment, if possible. Someone who goes with you can help you remember what the health care professional says.

What to expect from your doctor

Your health care team will probably ask a lot of questions. Be prepared to answer them you can save your time to go through any thing that you want to spend more time. Your health care team may ask:

  • When did you first notice the symptoms of your child?
  • Can you describe the symptoms of your child?
  • Does your child have breathing problems, such as running out of breath easily or fast breathing?
  • Does your child get tired easily?
  • Does your baby sweat profusely?
  • Does your child seem irritable?
  • Make your child's symptoms include pain in the chest?
  • Does your child often have cold feet?
  • When do these symptoms occur?
  • The symptoms come and go, or does your child always have?
  • The symptoms seem to get worse?
  • Do you have a family history of congenital heart defects?
  • Is there something that your child's symptoms better?

If you had coarctation of the aorta, your health care team may ask:

  • When did the symptoms begin?
  • The symptoms worsened over time?
  • Exercise or activity worsen your symptoms?
  • Have you been diagnosed with any other medical condition?
  • Do you have a family history of heart problems?
  • You are planning to become pregnant in the future?
Symptoms and treatment of Coarctation of the aorta