Coarctation of the aorta
Coarctation of the aorta is a narrowing (constriction) in a part of the body's main artery (aorta). The heart must pump more forcefully to send blood through the aorta and on to the rest of the body.
The aorta is the largest artery in the body. It moves oxygen-rich blood from the heart to the rest of the body. Aortic coarctation (ko-ahrk-TAY-shun) is a narrowing of the aorta. It forces the heart to pump harder to move blood through the aorta.
Coarctation of the aorta is generally present at birth (congenital heart defect). Symptoms can range from mild to severe. The condition might not be detected until adulthood.
Coarctation of the aorta often occurs along with other congenital heart defects. Treatment is usually successful, but the condition requires careful lifelong follow-up.
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Coarctation of the aorta symptoms depend on how much of the aorta is narrowed. Most people don't have symptoms. Mild coarctation may not be diagnosed until adulthood.
Babies with severe coarctation of the aorta may show symptoms shortly after birth. Symptoms of coarctation of the aorta in infants include:
- Difficulty breathing
- Difficulty feeding
- Heavy sweating
- Pale skin
Symptoms of coarctation of the aorta after infancy commonly include:
- Chest pain
- High blood pressure
- Leg cramps or cold feet
- Muscle weakness
Depending on where the coarctation is located, blood pressure may be high in the arms and low in the legs and ankles.
Coarctation of the aorta often occurs with other heart defects. Other symptoms depend on the type of congenital heart defect.
When to see a doctor
Seek medical help if you or your child has the following symptoms:
- Severe chest pain
- Sudden shortness of breath
- Unexplained high blood pressure
A complete health checkup helps determine the cause. If you or your child has sudden, unexplained chest pain, seek emergency medical care.
The cause of coarctation of the aorta is unclear. The condition is generally a heart problem present at birth (congenital heart defect).
Rarely, coarctation of the aorta develops later in life. Conditions or events that can narrow the aorta and cause this condition include:
- Traumatic injury
- Severe hardening of the arteries (atherosclerosis)
- Inflamed arteries (Takayasu arteritis)
Coarctation of the aorta can affect any part of the aorta, but it's most often located near a blood vessel called the ductus arteriosus. That blood vessel connects the left pulmonary artery to the aorta.
With coarctation of the aorta, the left lower heart chamber (left ventricle) works harder to pump blood through the narrowed aorta. As a result, blood pressure rises in the left ventricle. The wall of the left ventricle may become thick (hypertrophy).
Coarctation of the aorta is more common in males than in females. Having certain genetic conditions, such as Turner syndrome, also raises the risk of coarctation of the aorta.
Coarctation of the aorta often occurs along with other congenital heart defects. Heart conditions associated with coarctation include:
- Bicuspid aortic valve. The aortic valve separates the lower left chamber (left ventricle) of the heart from the aorta. A bicuspid aortic valve has two flaps (cusps) instead of the usual three. Many people with coarctation of the aorta have a bicuspid aortic valve.
- Subaortic stenosis. A narrowing of the area below the aortic valve blocks blood flow from the lower left heart chamber to the aorta.
- Patent ductus arteriosus. The ductus arteriosus is a blood vessel that connects the left lung (pulmonary) artery to the aorta. When a baby is growing in the womb, this vessel lets blood go around the lungs. Shortly after birth, the ductus arteriosus usually closes. If it remains open, the opening is called a patent ductus arteriosus.
- Holes in the wall between the left and right sides of the heart. Some people are born with a hole in the heart wall (septum) between the upper chambers (atrial septal defect) or the lower chambers (ventricular septal defect).This causes oxygen-rich blood from the left side of the heart to mix with oxygen-poor blood in the right side of the heart.
- Congenital mitral valve stenosis. This is a heart valve problem present at birth. The mitral valve is between the upper and lower left heart chambers. It lets blood flow through the left side of the heart. In mitral valve stenosis, the valve is narrowed, reducing blood flow. Symptoms include shortness of breath, difficulty breathing during exercise and shortness of breath when lying flat.
Prompt treatment is needed to help prevent complications. Without treatment, coarctation of the aorta in babies may lead to heart failure or death.
Long-term (chronic) high blood pressure is the most common complication of coarctation of the aorta. Blood pressure usually drops after repair surgery. But it may still be higher than usual.
Other complications of coarctation of the aorta may include:
- A weakened or bulging artery in the brain (brain aneurysm)
- Bleeding in the brain (hemorrhage)
- Aortic rupture or tear (dissection)
- Enlargement in part of the aorta's wall (aneurysm)
- Premature narrowing of the blood vessels that supply the heart (coronary artery disease)
If the coarctation of the aorta is severe, the heart might not be able to pump enough blood to the other organs. This can cause heart damage. It may lead to kidney failure or other organ failure.
Complications are also possible after treatment for coarctation of the aorta. These include:
- Aorta re-narrowing (re-coarctation, possibly years after treatment)
- High blood pressure
- Aortic aneurysm or rupture
People with coarctation of the aorta need regular health checkups for life.
There's no known way to prevent coarctation of the aorta. Early detection can help prevent complications. Talk to your health care provider if you or your child has a condition that increases the risk of aortic coarctation, such as Turner syndrome, bicuspid aortic valve or another heart defect. Also tell your provider if you have a family history of congenital heart disease.