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Aortic Coarctation—Child(Coarctation of the Aorta—Child)
Definition

The aorta is the main artery in the heart. It carries oxygen-rich blood from the heart to the body. Aortic coarctation is the narrowing of the aorta. This slows or blocks blood flow. It is often associated with other heart and vascular conditions. Examples include abnormal heart valves or aneurysms, which can lead to further health problems.

Anatomy of the Heart


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Causes

Aortic coarctation is a congenital heart defect. This means that it is present at birth. It occurs because of a problem with the way the aorta develops while the fetus is growing in the uterus.

Risk Factors

Aortic coarctation is more common in boys. Other factors that increase your child's risk of aortic coarctation include:

Symptoms

If your child’s condition is severe, they will have symptoms of impaired blood flow at birth. If aortic coarctation is not treated, it can lead to heart failure.

If this condition is not detected when your child is a baby, there may be other symptoms during childhood, such as:

  • Heart murmur
  • High blood pressure in the arms
  • A weak pulse in the legs
  • Cold legs and feet
  • Shortness of breath, especially with exercise
  • Legs that are underdeveloped, but better developed arms
  • Headaches
  • Lightheadedness
  • Fatigue
  • Chest pain

These symptoms may be caused by other conditions. If your child has any of these, talk to their doctor.

Diagnosis

The doctor will ask about your child's symptoms and medical history. A physical exam and blood tests will be done.

Imaging tests evaluate the heart and surrounding structures. This can be done with:

Treatment

Talk with the doctor about the best treatment plan for your child. Treatment depends on your child's age and how severe the condition is.

Treatment for Newborns

Your newborn will need treatment right away. Medications can be used to help blood flow to all parts of the body and improve contraction of the heart. One of the most common surgeries involves removing the narrow section of the aorta and reconnecting the two healthier ends.

Treatment for Children

Your child may need to take other medications to reduce fluid retention. Depending on your child’s condition, the doctor may also recommend surgery. Some of the options include:

  • Resection of the narrowed area in the aorta (the same type of surgery used in infants)
  • Subclavian flap aortoplasty—involves using a patch or part of the artery to make the area larger
  • Balloon angioplasty —involves using a balloon to widen the narrowed area

It is important to note that there will always be a risk, even into adulthood, of the development of other cardiovascular conditions.

Prevention

There are no current guidelines to prevent aortic coarctation.

RESOURCES:

American Heart Association
http://www.heart.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca

Canadian Society for Vascular Surgery
http://www.canadianvascular.ca

References:

Coarctation of aorta. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 5, 2014. Accessed June 10, 2015.

Coarctation of the aorta. Cincinnati Children’s website. Available at: http://www.cincinnatichildrens.org/health/c/coarctation. Updated December 2013. Accessed June 10, 2015.

Repair of coarctation of the aorta. Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/medical-care/herma-heart-center/for-medical-professionals/pediatric-heart-surgery/coarctation-of-the-aorta. Accessed June 10, 2015.

Rothman A, Galindo A, Evans W, Collazos J, Restrepo H. Effectiveness and safety of balloon dilation of native aortic coarctation in premature and neonates weighing < or = 2,500 grams. Am J of Cardiology. 2010;105(8):1176-1180.

Vijayalakshmi K, Griffiths A, Hasan A, O'Sullivan J. Late hazards after repair of coarctation of the aorta. BMJ. 2008;336(7647):772-773.



Last reviewed June 2015 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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