Tests and diagnosis

By Mayo Clinic Staff

The age at which coarctation of the aorta is diagnosed depends on the severity of the condition. If the aortic coarctation is severe, it's usually diagnosed during infancy. Testing for coarctation of the aorta before birth often isn't possible.

Adults and older children who are diagnosed with coarctation of the aorta may have milder cases and not have symptoms. They may often appear healthy until a doctor detects:

  • High blood pressure in the arms
  • A blood pressure difference between the arms and legs, with higher blood pressure in the arms and lower blood pressure in the legs
  • A weak or delayed pulse in the legs
  • A heart murmur — an abnormal whooshing sound caused by turbulent blood flow

Diagnostic tests

Tests to confirm a diagnosis of coarctation of the aorta may include:

  • Echocardiogram. Echocardiograms use high-pitched sound waves to produce an image of your heart. Sound waves bounce off your heart and produce moving images that can be viewed on a video screen.

    An echocardiogram can often detect the location and severity of the aortic coarctation and show other heart defects, such as a bicuspid aortic valve. Doctors often use echocardiograms to diagnose coarctation of the aorta and determine the most appropriate treatment options for you.

  • Electrocardiogram (ECG). An ECG records the electrical activity in your heart each time it contracts. During this procedure, patches with wires (electrodes) are placed on your chest, wrists and ankles. The electrodes measure electrical activity, which is recorded on paper or a computer monitor.

    If the coarctation of the aorta is severe, the ECG may show that the walls of the lower heart chambers are enlarged (ventricular hypertrophy).

  • Chest X-ray. A chest X-ray creates images of your heart and lungs. A chest X-ray might show an enlarged heart, a narrowing in the aorta at the site of the coarctation and an enlarged section of the aorta past the narrowed area.
  • Magnetic resonance imaging (MRI). An MRI uses a powerful magnetic field and radio waves to produce detailed images of your heart and blood vessels.

    An MRI can reveal the location and severity of the coarctation of the aorta, determine whether it affects other blood vessels in your body, and detect whether you have other heart defects. Doctors may also use this test to determine your treatment options.

  • Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create detailed cross-sectional images of your body.

    In a CT angiogram, your doctor injects a dye into a blood vessel to highlight blood flow in your arteries and veins. A CT angiogram allows your doctor to see the location and severity of the coarctation of the aorta, determine whether it affects other blood vessels in your body, and detect other heart defects. Doctors may use this test to determine your treatment options.

  • Cardiac catheterization. During this procedure, your doctor inserts a long, thin tube (catheter) into an artery or vein in your groin and threads it to your heart using X-ray imaging.

    Your doctor may inject a dye through the catheter to make your heart structures visible on X-ray pictures. Cardiac catheterization can help to determine the severity of the aortic coarctation. It can also measure pressure and oxygen levels in the chambers of the heart and in the blood vessels.

    This test isn't often used to diagnose coarctation of the aorta, but it may be done to help your doctors plan your surgery. Catheter procedures may be used to perform certain treatments for coarctation of the aorta.

Sept. 15, 2015