What is coarctation of the aorta?
The aorta is the main blood vessel that comes from the heart and supplies blood to the entire body. Coarctation (pronounced koh-ark-TAY-shun) of the aorta is a condition where the aorta has a very narrow area, making it shaped like an hourglass. Blood pressure increases above the narrow spot, and the left ventricle has to pump harder because the pressure is high. The heart may enlarge from this extra work, and its function may suffer if not treated.
Symptoms of coarctation of the aorta develop because the upper parts of the body get too much blood and the lower parts do not get enough.
In mild cases, where the aorta is slightly narrowed, babies may not have any symptoms.
If babies do have symptoms, they might have these:
- Working hard to breathe
- Having poor appetite or trouble feeding
- Failure to thrive
- Arms and legs that are cool to the touch
Later on, children may develop symptoms related to problems with blood flow and an enlarged heart. They may:
- Feel dizzy or short of breath
- Have chest pain
- Be abnormally tired
- Get headaches or nosebleeds
- Have cold legs and feet, or have pain in their legs when they exercise
In more severe cases, where the aorta is very narrow, babies may develop serious problems soon after birth because not enough blood can get through the aorta to the rest of their body.
Diagnosing Coarctation of the Aorta
Even though the narrow spot exists before birth, this condition may not be diagnosed until a routine exam reveals problems with your child’s pulse or blood pressure.
Your doctor will examine your child, use a stethoscope to listen to their heart and check their blood pressure in their arms and legs. The doctor will ask for details about any symptoms your child has, their health history and your family health history.
To get more information about how their heart looks and works, your child will need some tests.
Your doctor will probably want to use echocardiography and an electrocardiogram.
Sometimes, the doctor needs more information and will use chest X-rays, MRI (magnetic resonance imaging) of the heart, CT (computed tomography) scan or angiography. For an older child, the doctor may do exercise testing.
Treating Coarctation of the Aorta
Doctors can treat this condition with cardiac catheterization to open the narrow spot in the aorta (balloon angioplasty) or with surgery to remove that part of the aorta. The treatment plan depends on how severe the coarctation is and if there are other birth defects.
Some children can have their narrow aorta opened using catheterization instead of surgery. This method involves inserting a small tube (catheter) through an artery or vein and threading it up to the narrowed area. Then there are 2 options:
- A balloon can be inserted through the tube. When the balloon is inflated, the aorta is stretched open. Then, the balloon is removed. This is called balloon dilation.
- A stent can be placed at the narrow spot. A stent is a tube-shaped device that can be left inside a blood vessel to hold it open.
In addition to these treatments, your child may need medicines to treat problems related to their narrow aorta. These medicines may be used to improve the force of their heartbeat or control their blood pressure.