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  • Aortic Coarctation—Child

    (Coarctation of the Aorta—Child)

    Definition

    The aorta is the main artery in the heart. It carries oxygen-rich blood from the heart to the body. Aortic coarctation is the narrowing of the aorta. This slows or blocks blood flow. It is often associated with other heart and vascular conditions. Examples include abnormal heart valves or aneurysms, which can lead to further health problems.
    Anatomy of the Heart
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Aortic coarctation is a congenital heart defect. This means that it is present at birth. It occurs because of a problem with the way the aorta develops while the fetus is growing in the womb.

    Risk Factors

    Risk factors include:

    Symptoms

    If your child’s condition is severe, he will have symptoms of impaired blood flow at birth. If aortic coarctation is not treated, it can lead to heart failure .
    If this condition is not detected when your child is a baby, he may have these symptoms during childhood, such as:
    • Heart murmur
    • High blood pressure in the arms
    • A weak pulse in the legs
    • Cold legs and feet
    • Shortness of breath, especially with exercise
    • Legs that are underdeveloped, but better developed arms
    • Headaches
    • Dizziness
    • Fatigue
    • Chest pain
    These symptoms may be caused by other conditions. If your child has any of these, talk to the doctor.

    Diagnosis

    If your child’s condition is not detected at birth, the doctor will ask about his symptoms and medical history. A physical exam will also be done. Tests may include:
    • Blood tests
    • Chest x-ray —a test that uses radiation to take a picture of structures inside the chest
    • MRI of the heart—a test that uses magnetic waves to make pictures of structures inside the heart
    • CT scan of the heart—a type of x-ray that uses a computer to make pictures of structures inside the heart
    • Echocardiogram —a test that uses sound waves (ultrasound) to examine the size, shape, and motion of the heart
    • Cardiac catheterization (rarely needed)—a tube-like instrument inserted into the heart through a vein or artery (usually in the arm or leg) to detect problems with the heart and its blood supply

    Treatment

    Talk with the doctor about the best treatment plan for your child. Treatment depends on your child's age and how severe the condition is.

    Treatment for Newborns

    Your newborn will need treatment right away. An IV medicine (given through a vein) called prostaglandin may be given. This drug helps keep blood flowing to all parts of the body. Other medicines may also be used to improve how the heart contracts. One of the most common surgeries involves removing the narrow section of the aorta and reconnecting the two "good" ends.

    Treatment for Children

    Your child may need to take water pills to reduce fluid retention. Depending on your child’s condition, the doctor may also recommend surgery. Some of the options include:
    • Resection of the narrowed area in the aorta (the same type of surgery used in infants)
    • Subclavian flap aortoplasty—involves using a patch or part of the artery to make the area larger
    • Balloon angioplasty —involves using a balloon to widen the narrowed area
    It is important to note that there will always be a risk, even into adulthood, of the development of other cardiovascular conditions.

    Prevention

    Since this condition is present at birth, there is no way to prevent it.

    RESOURCES

    American Heart Association http://www.americanheart.org/

    National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/

    CANADIAN RESOURCES

    Canadian Cardiovascular Society http://www.ccs.ca/home/index%5Fe.aspx/

    Canadian Society for Vascular Surgery http://www.canadianvascular.ca/

    References

    Children’s Hospital of Wisconsin. Coarctation of the aorta. Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/display/PPF/DocID/21361/router.asp . Accessed June 2010.

    Cincinnati Children’s. Aortic coarctation. Cincinnati Children’s website. Available at: http://www.cincinnatichildrens.org/health/info/heart/diagnose/coarctation.htm . Updated September 2009. Accessed June 30, 2010.

    DynaMed Editorial Team. Aortic coarctation. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 2010. Accessed June 30, 2010.

    McCoy K. Aortic coarctation. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated September 2009. Accessed June 30, 2010.

    Rothman A, Galindo A, Evans W, Collazos J, Restrepo H. Effectiveness and safety of balloon dilation of native aortic coarctation in premature and neonates weighing <2,500 grams. Am J of Cardiology . 2010;105:1176-1180.

    Vijayalakshmi K, Griffiths A, Hasan A, O'Sullivan J. Late hazards after repair of coarctation of the aorta. BMJ . 2008;336:772-773.

    Revision Information

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