aortic coarctation

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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.
References in periodicals archive ?
(24.) Kountouris E, Potsis T, Nikas D, Siogas K A severe coarctation of aorta in a 72-year-old female: a case report.
High index of suspicion for coarctation of aorta in any newborn with signs of respiratory distress should be maintained and early detection can result in reduction in the morbidity and mortality associated with a late diagnosis.
Here we are presenting a case of Coarctation of aorta with Takayasu arteritis posted for LSCS done successfully under epidural anaesthesia.
Indication of elective LSCS was gross IUGR in a patient with ASD, one patient of secondary infertility with Cephalopelvic disproportion, to avoid postdatism in a patient with rhesus negative pregnancy, coarctation of aorta in one patient and severe pulmonary artery hypertension in three patients.
HT in adolescence is usually secondary and can be caused by conditions like renal parenchymal diseases, nephrotic syndrome, renovascular diseases, drug-induced HT, tumors, coarctation of aorta, bronchopulmonary dysplasia or pheochromocytoma (5).
We believe that careful evaluation of children with congenital heart disease especially coarctation of aorta and symptoms of cerebral ischemia is warranted to detect the presence of Moyamoya disease.
Congenital mitral valve diseases commonly associated with obstructive malformation of left ventricular outflow tract, valvular and subvalvular aortic stenosis and coarctation of aorta (4).