aortic coarctation


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Related to aortic coarctation: aortic stenosis

aortic coarctation

congenital narrowing of the aorta, usually located just distal to the left subclavian artery, causing upper-extremity hypertension, excess left ventricular workload, and diminished blood flow to the lower extremities and abdominal viscera.

aortic coarctation

A congenital heart defect which occurs in 7% of patients with congenital heart disease; male:female ratio, 2:1. Aortic coarctation is characterised by narrowing of the aortic lumen, often distal to the origin of the left subclavian artery at the site of the aortic ductal attachment (the ligamentum arteriosum); extensive collateral arterial circulation develops though the internal thoracic, intercostal, subclavian and scapular arteries to supply the rest of the body in patients with AC.
 
Clinical findings
Rarely asymptomatic; headaches, dizziness, fainting, nosebleeds, decreased pulses, palpitations, rib notching and muscle cramps in legs with activity.

Associations
Gonadal dysgenesis (Turner syndrome), patent ductus arterisus, ventricular septal defect, bicuspid aortic valve, mitral stenosis or regurgitation or aneurysms of the circle of Willis.
 
Physical examination
Systolic and diastolic arterial pressure higher in arms than legs; femoral pulse is weak, delayed; possible findings include systolic thrill palpable in the suprasternal notch, LV hypertrophy, systolic ejection click due to bicuspid aortic valve, harsh systolic ejection murmur along the left strernal border and a systolic murmur heard in the back EKG LV hypertrophy.
 
Complications
Left ventricular failure, premature CAD, infective endocarditis, CVAs due to rupture of intracranial aneurysms.
 
Management
Surgical repair if transcoarctation pressure gradient is > 30 mm Hg; the earlier the repair, the less likely is the patient to have persistent or recurrent hypertension.

aortic coarctation

Coarctation of aorta Cardiology A congenital heart defect which occurs in 7% of Pts with CHD; ♂ ♀ ratio, 2:1; AC is characterized by narrowing of the aortic lumen, often distal to the origin of the left subclavian artery at the site of the aortic ductal attachment–the ligamentum arteriosum; extensive collateral arterial circulation develops though the internal thoracic, intercostal, subclavian and scapular arteries to supply the rest of the body in Pts with AC Clinical Rarely asymptomatic; headaches, dizziness, fainting, nosebleeds, ↓ pulses, rib notching and muscle cramps in legs with activity, palpitations; may be associated with gonadal dysgenesis–Turner syndrome, PDA, VSD, bicuspid aortic valve, mitral stenosis or regurgitation or aneurysms of the circle of Willis PE Systolic arterial pressure higher in arms than legs; diastolic pressure the same; femoral pulse is weak, delayed; possible findings include systolic thrill palpable in the suprasternal notch, LV hypertrophy, systolic ejection click due to bicuspid aortic valve, harsh systolic ejection murmur along the left strernal border, and a systolic murmur heard in the back EKG LV hypertrophy Imaging CXR-notching of ribs due to ↑ collateral flow through the IC arteries; pre– and poststenotic dilatation of the aorta yields the reverse E or '3' sign; other imaging modalities include echocardiography, Doppler, CT, MRI, contrast aortography Complications Left ventricular failure, premature CAD, infective endocarditis, CVAs due to rupture of intracranial aneurysms Management Surgical repair, if transcoarctation pressure gradient is > 30 mm Hg; the earlier the repair, the less likely is the Pt to have persistent or recurrent HTN. See Aortic stenosis.

a·or·tic co·arc·ta·tion

(ā-ōr'tik kō-ahrk-tā'shŭn)
Congenital narrowing of the aorta, usually located just distal to the left subclavian artery, causing upper extremity hypertension, excess left ventricular workload, and diminished blood flow to the lower extremities and abdominal viscera.

aortic

pertaining to or emanating from the aorta. See also aortic arch.

aortic aneurysm
occurs most often in dogs, where it is caused by Spirocerca lupi larvae, turkeys and primates, causing dyspnea, cyanosis and coughing. May be congenital affecting the aortic trunk and the arch sometimes associated with aneurysm of an aortic sinus. See also copper nutritional deficiency.
aortic aneurysm, inherited
see inherited aortic aneurysm.
aortic annulus fibrosus
the fibrous ring in the wall of the root of the aorta. In the bovine heart the ring carries the ossa cordis (see os2 cordis).
aortic base rupture
rupture of the vessel just above the semilunar valves.
aortic bodies
small neurovascular structures on either side of the aorta in the region of the aortic arch. The left body is located at the angle between the left subclavian artery and the aorta, and the right at the junction of the right subclavian and right common carotid arteries. They contain chemical receptors which send impulses through the afferent branches of the vagus nerve and are involved in regulating respiration so as to ensure an appropriate partial pressure of oxygen in the arterial blood.
aortic body tumors
single or multiple nodules within the pericardial sac near the base of the heart. Malignant tumors may invade the anterior mediastinum. Called also heart base tumor.
aortic bulb
the dilated part of the aorta at its origin, caused by the swellings of the aortic sinuses.
aortic coarctation
constriction of the aorta at the site of entry of the ductus arteriosus causing a syndrome similar to that of stenosis of the aortic valve.
aortic cystic medionecrosis
pools of ground substance within the elastic media of the aorta. May predispose to arterial aneurysm but this material is present in the aortas of normal horses.
aortic depressor nerve
pressure receptors in the aortic arch and thoracic aorta which assist in maintaining circulatory equilibrium by communicating pressure changes through the aortic depressor nerve, an afferent branch of the vagus nerve; stimulation causes heart slowing and vasodilation.
aortic dextraposition
the aorta receives blood from the right ventricle. There are a number of variations of the basic defect. The common one is the aorta overriding the septum, which is defective, so that the aorta receives blood from both ventricles. The clinical syndrome includes dyspnea and cyanosis from birth, usually with a loud systolic murmur. Affected animals are not viable.
aortic embolism
occurs in cats in association with feline cardiomyopathy and rarely in dogs. Acute pain with paresis to paralysis in the hindlegs, cold, cyanotic feet and no femoral pulse are signs of the condition.
aortic hiatus
an opening in the diaphragm through which the aorta, thoracic duct, the right and/or left azygos veins pass.
aortic-ilial embolism
see iliac artery thrombosis.
aortic mineralization
is one of the early lesions in poisoning by plants that induce mineralization of tissues, e.g. solanummalacoxylon. In combination with lesions in the myocardium causes a syndrome of congestive heart failure.
aortic nerve
see cardiac depressor nerve.
aortic palpation
the aorta is easily palpable per rectum in cattle and horses; valuable as a clinical sign only in cases of thrombosis at the bifurcation; incision at this point has been used as a means of euthanasia in an emergency.
aortic-pulmonary window
an anomaly of the aorta in which there is an opening between the ascending portion of the aorta and the pulmonary artery; clinical signs are similar to those of patent ductus arteriosus, but surgical correction is much more difficult.
aortic regurgitation
see valvular regurgitation.
aortic root
the part of the aorta attached to the atrioventricular fibrous rings and myocardium.
aortic rupture
1. in horses is caused by weakening of the wall of the aorta by migrating strongyle larvae. In cattle the cause may be onchocerciasis, in pigs experimental diets deficient in copper. Sudden death results from cardiac tamponade or dissecting aneurysm into the ventricular muscle.
2. sudden death in growing turkeys due to dissecting aneurysmal rupture of the aorta and death due to internal hemorrhage; the cause is unknown. Copper deficiency is suspected as a cause in several animal species.
aortic sac
the merged ventral aortae of the embryo which supplies blood to the aortic arches.
aortic septal defect
a congenital anomaly in which there is abnormal communication between the ascending aorta and the pulmonary artery just above the semilunar valves.
aortic sinus
the three pouch-like dilatations of the aortic bulb which carry the cusps of the aortic valve. The coronary arteries arise from the left caudal and the cranial sinuses.
aortic subvalvular stenosis
in dogs and pigs is possibly an inherited defect. Characterized by stenosis of the aorta just below the semilunar valves. In pigs, it causes congestive heart failure in the newborn, but in affected dogs severity increases with age so that clinical effects may not be apparent until the patients are older.
aortic thromboembolism
thrombosis is the usual forerunner of embolism, pieces of the thrombus breaking off the main mass and lodging in more distal parts of the vascular system. See also aortic embolism (above), verminous mesenteric arteritis, iliac artery thrombosis.
Enlarge picture
Aortic thromboembolism in a cat. By permission from Nelson RW, Couto CG, Small Animal Internal Medicine, Mosby, 2003
aortic valve
the valve at the entrance to the aorta from the left ventricle made up of three semilunar leaflets or valvulae.
aortic valve rupture
rupture of the medial cusp is recorded as a cause of sudden death in horses usually as a sequel to endocarditis.
aortic valvular disease
stenosis is rarely an acquired disorder, but may be an inherited defect in several species. In cats and rarely dogs, restrictive cardiomyopathy may be a cause of subvalvular aortic obstruction. Valvular incompetence may be congenital or acquired and results in diastolic overloading of the left ventricle with a characteristic water-hammer pulse and diastolic murmur. See also aortic stenosis, aortic subvalvular stenosis (above).
aortic vestibule
the cranial part of the left ventricular cavity leading to the root of the aorta in the avian heart.
References in periodicals archive ?
Aortic coarctation is a potentially life-threatening congenital lesion that often requires surgical or percutaneous intervention.
This type of aortic coarctation involves neonates and infants, and cardiac anomalies, such as a bicuspid aortic valve, ventricular septal defect, and patent ductus arteriosus, commonly coexist (1).
We report a case with Moyamoya disease with aortic coarctation and CBT presented with acute convulsion and right hemiparesis.
There is little information concerning patients with active native valve endocarditis and the aortic coarctation.