Coarctation of the aorta Health Article

Definition

Aortic coarctation is a narrowing of part of the aorta (the major artery leading out of the heart). It is a type of birth defect. Coarctation means narrowing.

Alternative Names

Aortic coarctation

Causes, incidence, and risk factors

The aorta carries blood from the heart to the vessels that supply the body with blood and nutrients. If part of the aorta is narrowed, it is hard for blood to pass through the artery.

Aortic coarctation is more common in persons with certain genetic disorders, such as Turner syndrome. However, it can also be due to birth defects of the aortic valves.

Aortic coarctation is one of the more common heart conditions that are present at birth (congenital heart conditions). It is usually diagnosed in children or adults under age 40.

Coarctation of the aorta may be seen with other congenital heart defects, such as:

• Bicuspid aortic valve
• Defects in which only one ventricle is present
• Ventricular septal defect

Symptoms

Symptoms depend on how much blood can flow through the artery. Other heart defects may also play a role.

Around half of newborns with this problem will have symptoms in the first few days of life.

In milder cases, symptoms may not develop until the child has reached adolescence. Symptoms include:

• Dizziness or fainting
• Shortness of breath
• Pounding headache
• Chest pain
• Cold feet or legs
• Nosebleed
• Leg cramps with exercise
• High blood pressure (hypertension) with exercise
• Decreased ability to exercise
• Failure to thrive
• Poor growth

Note: There may be no symptoms.

Signs and tests

The health care provider will perform a physical exam and take your blood pressure and pulse in your arms and legs.

• The pulse in the femoral (groin) area or feet will be weaker than the pulse in the arms or the carotid (neck). Sometimes, the femoral pulse may not be felt at all.
• The blood pressure in your legs is usually weaker than in the arms. Blood pressure is usually higher in the arms after infancy.

The doctor will use a stethoscope to listen to your heart and check for murmurs. People with aortic coarctation have a harsh-sounding murmur that can be heard from the back. Other types of murmurs may also be present.

Coarctation is often discovered during a newborn's first examination or well-baby exam. Taking the pulses in an infant is an important part of the examination, because there may not be any other symptoms or findings until the child is older.

Tests to diagnose this condition may include:

• Echocardiography is the most common test to diagnose this condition, and it may also be used to monitor the patient after surgery
• Chest x-ray
• Heart CT may be needed in older children
• MRI or MR angiography of the chest may be needed in older children
• Cardiac catheterization and aortography

Both Doppler ultrasound and cardiac catheterization can be used to see if there are any differences in blood pressure in different areas of the aorta.