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.
References in periodicals archive ?
Comparison of surgical and interventional therapy of native and recurrent aortic coarctation regarding different age groups during childhood.
A late presentation of Dandy-Walker malformation and aortic coarctation. J Cardiovasc Med (Hagerstown) 2009.
Aortic coarctation repair in neonates with intracardiac defects: The importance of preservation of the lesser curvature of the aortic arch.
Cardiac transplantation and aortic coarctation repair in severe heart failure.
Her CT scan findings suggested bicuspid aortic valve, severe juxtaductal aortic coarctation, and postcoarctated descending thoracic aorta (DTA) that was mildly dilated.
Recent guidelines on endovascular treatment of aortic coarctation have been published by the American Heart Association.
(3) Literature on the concomitant treatment of aortic coarctation and coronary artery disease is limited.
The patient was subsequently diagnosed with aortic coarctation and was deemed unfit for surgical intervention.
Other common causes of neonatal hypertension such as hypervolemia due to oliguric renal damage; structural renal diseases such as polycystic kidney disease, aortic coarctation, and obstructive uropathy; medications such as corticosteroids; endocrine disorders; and bronchopulmonary dysplasia may be considered.
KEY WORDS: Subclavian flap angioplasty Aortic coarctation Children
We herein describe a case of a 10-year-old girl who was diagnosed with aortic coarctation, which was surgically corrected at the age of 11 days.
These studies have shown that, in rats (1) and mice (2,3) with suprarenal abdominal aortic coarctation and mice with two-kidney one-clip (2K1C) Goldblatt hypertension (4), thoracic aortic tissues concurrently present upregulation of A[T.sub.2]R mRNA, depression of the contractile responses to ANG II that are mediated by upregulated A[T.sub.2]R, and an endothelium-dependent increase in the production of cyclic guanosine monophosphate (cGMP).