Acyanotic congenital heart disease - obstructive lesions

Question 1

Coarctation of the aorta

Answer 1

M:F 2:1
Narrowing of aorta (pre or postductal)
Severity determines clinical features, can range from severely ill child to asymptomatic child (or adult) with HT

Question 2

Preductal coarctation: symptomatic infants

Answer 2

Often diagnoses antenatally
Sick neonate, absent femorals
Whilst the ductus arterious is open, the RV can maintain adequate CO to the systemic circulation; cardiac failure occurs when duct closes
Prostaglandin infusion to maintain a PDA and transfer to a cardiac centre for surgery

Question 3

Postductal coarctation: asymptomatic children

Answer 3

Usually asymptomatic
May be leg pains or headache
Hypertension in arm
Weak/absent femoral pulses