Coarctation of the aorta (aortic coarctation) is a condition involving a narrowing of the body's large blood vessel (aorta) that delivers oxygenated blood from the heart muscle to the body. When the aorta narrows, it causes the heart to pump harder to ensure blood flow is pushed through the narrow portion of the aorta.
Typically, coarctation of the aorta is a congenital defect that presents itself at birth. Individuals may experience mild to severe coarctation that is often not identified until adulthood. This congenital defect can be presented with other defects at birth. Scientists of yet to determine an effective way to treat court case and of the aorta, requiring careful monitoring throughout the patient's life.
- Who Is at Risk for Coarctation of the Aorta?
- What Causes Coarctation of the Aorta?
- Common Symptoms
- Diagnosing Coarctation of the Aorta
- Treating the Condition
Who Is at Risk for Coarctation of the Aorta?
While any individual can develop coarctation of the aorta, there are certain risk factors including a congenital heart defect that are known to cause the condition. Individuals that are more likely to develop serious heart conditions including coarctation of the aorta are those that have other medical conditions including:
- Bicuspid Aortic Valve – Typical aortic valves develop with three flaps that separate the left ventricle (lower left chamber) of the heart from the aorta. Bicuspid aortic valves still work but are defective in their design that can lead to coarctation of the aorta.
- Aortic Valve Stenosis – The valve separating the aorta (aortic valve) from the heart's left ventricle can narrow causing the heart to pump harder to push sufficient blood flow to the entire body. Without intervention, the stenosis causes a thickening of the heart muscle that could result in heart failure.
- Patent Ductus Arteriosus – This condition usually develops before birth when the blood vessel that connects the left pulmonary artery to the large blood vessel (aorta) allows blood flow to bypass the lungs. This defect typically closes without intervention shortly after birth. However, when the condition remains open, doctors refer to the defect as patent ductus arteriosus.
- Aortic Valve Regurgitation – If the aortic valve cannot close completely and tightly, it causes the flow of blood to leak backward into the heart's left ventricle.
- Hole in the Heart – If a hole develops between the right and left sides of the heart when being developed in the womb it can cause oxygenated blood from the heart's left side to mix with oxygen-spent blood from the right side.
- Mitral Valve Regurgitation – If the mitral valve is unable to close completely and tightly, they can cause blood flow to leak backward into the heart's left atrium.
- Mitral Valve Stenosis – The mitral valve located between the left ventricle in the left atrium (upper left part chamber) can narrow, causing the flow of blood to back up into the left side of the heart and lungs which can cause lung congestion and shortness of breath. Without intervention, the condition can progress and cause heart failure.
Coarctation of the aorta is a common occurrence in individuals who have acquired Turner's syndrome or other genetic condition. Females with Turner's syndrome are missing and X chromosome or have an incomplete X chromosome. Approximately one out of every ten girls and women with Turner's syndrome are diagnosed with coarctation of the aorta.
Untreated aortic coarctation often leads to severe complications that include high blood pressure, heart failure, stroke, aortic dissection (tearing or rupturing), aneurysms where the aorta enlarges, and bulging or weakening arteries in the brain (brain aneurysms), or bleeding in the brain (hemorrhaging).
In severe cases of aortic coarctation, the heart often lacks the capacity to pump sufficient quantities of blood out to the body's organs and cause a considerable damage to the heart. Untreated coarctation of the aorta can also cause other organs to fail, including the kidneys.
What Causes Coarctation of the Aorta?
Doctors, scientists, and researchers have yet to determine the exact cause of aortic coarctation (coarctation of the aorta). Some cases are congenital, meaning they develop while the fetus is in the womb. However, other aortic coarctation conditions develop later in life. Scientists believe the term injuries could lead to the development of coarctation of the aorta. In rare cases, atherosclerosis (hardening of the arteries) or Takayasu's arteritis (inflamed arteries) can cause the aorta to narrow and eventually cause coarctation.
The condition usually develops beyond the bodies large blood vessels by branching off to the blood vessels that feed the lower and upper body. This often develops with the high blood pressure in the arms and lower blood pressure in the ankles and legs. The condition also causes the heart to pump significantly harder to pass sufficient quantities of oxygenated blood through the narrow aorta. By overworking through constricted artery, the blood pressure increases and can begin to thicken (hypertrophy) the walls of the left ventricle.
The type of symptoms a patient with coarctation of the aorta experience will depend on the condition severity. Many individuals never have any symptoms and many are never diagnosed until they reach adulthood. Typically, babies suffering from aortic court patient will show many of the symptoms immediately after being born. These include:
- Heavy sweating
- Difficulty in feeding
- Difficulty in breathing
- Pale skin
Without effective treatment, the baby suffering with aortic coarctation could have heart failure or die from the condition.
In children and adults, the most common coarctation of the aorta symptoms involve:
- High blood pressure
- Cold feet or leg cramps
- Muscle weakness
- Chest pain
Any individual suffering symptoms involving fainting, severe chest pain, unexplained high blood pressure or sudden shortness of breath should seek out immediate medical attention.
Diagnosing Coarctation of the Aorta
Diagnosing coarctation of the aorta is sometimes challenging. Many cases are not accurately diagnosed until the symptoms become severe that might occur by after birth or later in life. The doctor will gather a comprehensive family and personal medical history and perform a complete physical examination to identify noticeable symptoms associated with the condition including:
- High blood pressure in the arms when there is low blood pressure in the legs and ankles
- Heart murmur produced by turbulent blood flow
- Delayed or week and pulse in the legs
The doctor will also perform diagnostic tests that include:
- Chest x-rays
- MRI (magnetic resident imaging) scan
- CT (computerized market) scan
- Cardiac catheterization
While no test can accurately diagnosed aortic court patient, the results of all of them can assist the doctor in planning an effective treatment.
Treating the Condition
The doctor will recommend one or more treatment options depending on the patient's age, the severity of the condition and other factors that might the involved in achieving a successful outcome. Most approaches for treatment include balloon angioplasty, which is a surgical procedure that increases the interior dimension of the narrowed aorta. Other treatments involve:
- Resection Surgery
- Sub-Clavian Flap Aortoplasty
- Bypass Graft Repair
- Patch Aortoplasty
The doctor might also prescribe medications to repair aortic court patient or control blood pressure before the patient undergoes a surgical procedure. Even after successful treatments, coarctation of the aorta can recur, oftentimes many years after successful treatments.