Coarctation of the Aorta Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Coarctation of the aorta is a condition characterized by a narrowing of the aorta, which is a large blood vessel from the heart with the function of delivering oxygen-rich blood to various parts of the body. When this condition occurs, the heart has to pump blood harder to push the blood to pass through the narrowed part of the aorta.
Coarctation of the aorta generally occurs from birth. This condition can vary, from mild to severe, and sometimes not detected until adulthood, depending on the degree of narrowing that occurs in the aorta.
Coarctation of the aorta often occurs together with other heart defects. Although treatment generally has good results, this condition often requires long-term monitoring.
Symptoms
The signs and symptoms of coarctation of the aorta depend on the severity of the condition. Most individuals show no signs or symptoms.
Children with significant aortic stenosis may show early signs and symptoms. While mild cases may not show signs and symptoms at all until they are diagnosed in adulthood.
In babies with severe coarctation of the aorta, signs and symptoms can appear shortly after birth, including:
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Pale skin
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Fussy
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Excessive sweat production
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Difficulty breathing
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Difficulty breastfeeding
Children and adults with coarctation of the aorta often do not show the same signs and symptoms as infants. This is because the narrowing that occurs can be lighter. In people who started showing symptoms after infancy, it is often found that there is an increase in blood pressure in the arms, which exceeds the blood pressure in the legs.
Some of the signs and symptoms that can be observed in children and adults are:
- Increased blood pressure
- Headache
- Muscle weakness
- Leg cramps
- Nosebleeds
- Chest pain
Cause
The cause of the coarctation of the aorta is not known for certain. Although coarctation of the aorta can occur in any part of the aortic blood vessel, the narrowing is most often found located near the blood vessel known as the ductus arteriosis. This condition generally occurs before birth.
In rare cases, coarctation of the aorta can occur after childhood. For example, due to injury or other health conditions that cause hardening or inflammation of the arterial blood vessels.
Coarctation of the aorta usually occurs in the part of the aorta that branches to supply blood to the upper body. As a result, there is often an increase in blood pressure in the arms but not in the legs and ankles.
In coarctation of the aorta, the lower left chamber of the heart, the left ventricle, works harder to pump blood through the narrowed aorta, and the blood pressure in the left ventricle increases. This can cause the walls of the left ventricle to become thicker, which is called hypertrophy.
Coarctation of the aorta often occurs together with other congenital heart diseases, although the cause of multiple heart defects that occur simultaneously is not yet known. This condition occurs more often in men than women, and also in people with certain genetic conditions, such as Turner syndrome.
Diagnosis
Coarctation of the aorta can be diagnosed from a medical interview, direct physical examination, and certain supporting examinations. The age at which the diagnosis of coarctation of the aorta is determined can depend on the severity of the condition.
In severe coarctation of the aorta, the condition is generally diagnosed before the age of one year. Older children and newly diagnosed adults generally do not show any specific symptoms and appear healthy, until the doctor detects high blood pressure in the arm, a difference in blood pressure between the arm and leg, or the presence of a slow and weak pulse in the leg.
Some of the supporting examination options that can be done to diagnose coarctation of the aorta are:
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Echocardiogram
This test uses sound waves to produce an image of the heart. An echocardiogram can detect the location and degree of severity of coarctation of the aorta and see the presence of any heart defects.
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Electrocardiogram (EKG)
An EKG examination evaluates the electrical activity of the heart. In this procedure, electrodes connected to cables will be placed at certain points on the chest, as well as the wrists and legs. The results of the inspection will be recorded on paper or on the monitor.
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Chest X-ray photo
A chest X-ray produces images of the lungs and heart, which can show the presence of coarctation of the aorta and the location of the narrowing.
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Magnetic resonance imaging (MRI)
This examination uses a strong magnetic field and radio waves to produce detailed imaging of the heart and blood vessels. An MRI examination can show the location and degree of severity of coarctation of the aorta, determine if there are other blood vessels in the body involved, and detect the presence of other heart defects.
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Computer tomography (CT)
This examination uses serial X-rays to produce imaging of the organs in the body. With this, the doctor can also see the location and degree of severity of coarctation of the aorta.
Handling
Treatment options for coarctation of the aorta depend on the age at diagnosis and the severity of the condition experienced. Some types of handling approaches that can be done are:
- Surgery. There are several types of surgical techniques that can be performed to repair the coarctation of the aorta. The doctor can discuss the operative action that can be the most suitable option for the patient.
- Balloon angioplasty and stent placement. The balloon angioplasty procedure, which is often followed by the installation of a stent, is one option to deal with aortic narrowing that occurs postoperatively.
In this procedure, the doctor inserts a catheter into an arterial blood vessel in the groin and traces it through the blood vessels in the body to the heart using X-ray imaging. Afterward, the doctor will insert an unexpanded balloon through the aorta and expand it, which makes the aorta become wider and facilitate blood flow.
- Treatment. Treatment has no direct impact in dealing with coarctation of the aorta. However, it can be used to control blood pressure before and after stent placement or surgery. Although treating coarctation of the aorta can improve blood pressure, some sufferers still need treatment for blood pressure.
Prevention
There is no known prevention method for coarctation of the aorta, as this condition is generally present at birth. However, if a person has a health condition related to coarctation of the aorta, such as Turner syndrome, bicuspid aortic valve, other heart defects, or a history of congenital heart disease in family members, then early detection can help speed up treatment for this condition.