Aortic Coarctation

Summary about Disease


Aortic coarctation is a congenital heart defect characterized by a narrowing of the aorta, the main artery that carries blood from the heart to the rest of the body. This narrowing restricts blood flow, forcing the heart to work harder to pump blood through the aorta. The severity of coarctation can vary, ranging from mild to severe.

Symptoms


Symptoms vary depending on the severity of the coarctation and the age of the individual.

Infants:

Poor feeding

Failure to thrive

Rapid breathing

Sweating

Pale skin

Cold feet or legs

Heart failure

Older Children and Adults:

High blood pressure in the arms

Low blood pressure in the legs

Headaches

Nosebleeds

Leg cramps with exercise

Cold feet

Dizziness

Fainting

Chest pain

Causes


Aortic coarctation is a congenital defect, meaning it is present at birth. The exact cause is often unknown, but it's thought to result from problems during heart development in the womb. It is sometimes associated with other congenital heart defects, such as bicuspid aortic valve. Genetic factors may also play a role.

Medicine Used


Medications used to manage aortic coarctation are directed at controlling symptoms and stabilizing the patient before intervention.

Prostaglandin E1 (PGE1): Used in infants to keep the ductus arteriosus open, which can improve blood flow to the lower body until surgery or other interventions can be performed.

Diuretics: To reduce fluid overload, especially in infants with heart failure.

Inotropes: Medications to strengthen the heart's contractions in cases of heart failure.

Antihypertensives: Used to manage high blood pressure, particularly after surgical repair or stenting, and in older individuals.

Is Communicable


Aortic coarctation is not communicable. It is a congenital heart defect, not an infectious disease.

Precautions


There are no specific precautions to prevent aortic coarctation, as it is a congenital condition. After treatment, patients may need to take precautions to prevent endocarditis (infection of the heart valves), such as informing dentists and doctors about their condition before procedures. Regular follow-up with a cardiologist is crucial for monitoring and managing any potential complications.

How long does an outbreak last?


Aortic coarctation is not an outbreak-related disease.

How is it diagnosed?


Diagnosis typically involves:

Physical Exam: Checking blood pressure in arms and legs, listening for heart murmurs.

Echocardiogram: Ultrasound of the heart to visualize the aorta and blood flow.

Electrocardiogram (ECG or EKG): Measures the electrical activity of the heart.

Chest X-ray: Can show an enlarged heart or other abnormalities.

Cardiac Catheterization: A catheter is inserted into a blood vessel and guided to the heart to measure pressures and visualize the aorta.

MRI or CT Scan: Can provide detailed images of the aorta.

Timeline of Symptoms


Infants: Symptoms may appear within the first few days or weeks of life.

Children/Adults: Symptoms may be subtle and develop gradually, often noticed during routine physical exams or during periods of increased physical activity. Some individuals may remain asymptomatic until adulthood, with the condition discovered incidentally.

Important Considerations


Early diagnosis and treatment are crucial to prevent long-term complications, such as high blood pressure, heart failure, stroke, and aortic rupture.

Treatment options include surgical repair (resection of the narrowed segment or patch aortoplasty) and balloon angioplasty with or without stenting.

Lifelong follow-up with a cardiologist is necessary to monitor for recurrence of coarctation, development of aneurysms, and other potential issues.

Individuals with repaired aortic coarctation may need to avoid strenuous activities that could put excessive strain on the aorta, especially if residual narrowing or aneurysms are present.

Genetic counseling may be considered if there's a family history of congenital heart defects.