Aortic coarctation

Question 1

What is aortic coarctation?

Answer 1

Refers to a congenital heart condition where there is a narrowing of the aortic arch.

Typically occurs just before the ductus arteriosus.

Question 2

What genetic condition is aortic coarctation associated with?

Answer 2

Turners syndrome

Question 3

Risk factors of aortic coarctation?

Answer 3

Men>women
Turners syndrome
Patent ductus arteriosus
Ventricular septal defect
Mitral stenosis/regurgitation
Circle of Willis aneurysms

Question 4

Presentation of aortic coarctation?

Answer 4

Asymptomatic for many years
Headaches and nose bleeds due to HTN
Claudication and cold legs (poor perfusion to lower limbs)
Heart failure
Systolic murmur
Neonatal shock

HTN in upper limbs
Radio-femoral delay (will feel the radial pulse before the pulse in the groin)
Weak delayed pulses in legs

Question 5

Investigations for aortic coarctation?

Answer 5

Echocardiography (diagnosis; visualise the narrowing of the aorta)

CXR

ECG (left ventricular hypertrophy)

Question 6

Management of aortic coarctation?

Answer 6

Depends on the severity.

Mild:
- monitor via echocardiography
- antihypertensives (control BP if needed)

Severe:
- surgical correction (angioplasty and stent insertion)

Neonates presenting in shock:
- administer prostaglandin (keeps the ductus arteriosus patent until the defect can be corrected)