Coarctation of the Aorta

Complications of Coarcation of the Aorta

Complications may include:

Heart Enlargement The obstruction in the aorta causes the heart to work harder to pump blood forward past the obstruction. Over time the heart may not be able to keep up with the extra workload. The left ventricle (main pumping chamber) may become thickened (hypertrophied), enlarged, inefficient and eventually fail.

High and Low Blood Pressure The obstruction in the aorta increases blood pressure in the arteries behind the obstruction and decreases blood pressure and blood flow in the arteries beyond the obstruction. The result is higher blood pressure in the arms but lower blood pressure in the legs since the area below the obstruction receives less blood flow.

Kidney Damage The kidneys are especially sensitive to changes in blood pressure and blood flow and may not function as effectively or may become damaged over time from the decreased blood flow caused by the obstruction in the aorta. Since an important function of the kidneys is to help control blood pressure, kidney damage can compound the problems associated with high blood pressure caused by the coarctation.

Weakened Aorta Segments of the aorta may become enlarged because of the increased pressure and turbulent blood flow caused by the obstruction. As the aorta enlarges, the walls may become weak and prone to dilation, rupture or dissection (tear in the artery wall). There is an increased risk of brain artery enlargement (intracranial aneurysm) in patients with coarctation. Intracranial aneurysm ruptures are life threatening and may cause permanent neurologic complications.

Risk of Infection People with coarctation of the aorta, repaired or not, are at increased risk for infective endocarditis (infection inside the heart and valves of the heart) and endoarteritis (infection of the inside layers of an artery) because of altered arterial wall structure and the effect of abnormal blood flow and pressures. This risk is increased further if a bicuspid aortic valve is present. Lifelong endocarditis precautions are necessary.

Coronary Artery Disease The coronary arteries may develop premature narrowing or atherosclerosis as a response to the increased blood pressure, which may result in coronary artery disease with an increased risk of a heart attack or angina in early to midadulthood.