Coarctation of the aorta

Question 1

What is coarctation of the aorta?

Answer 1

Congenital narrowing of descending aorta (usually before ductus arteriosus)

Question 2

More common in which patients?

Answer 2

Males (despite Turner’s syndrome association)

Question 3

Specific feature in infancy?

Answer 3

Heart failure

Question 4

Specific feature in adulthood?

Answer 4

Hypertension

Question 5

Signs?

Answer 5

1) Radio-femoral delay
- -> BP difference
- -> O2 sats difference
2) Mid-systolic murmur, max over back (between shoulder blades)
3) Apical click from aortic valve

Question 6

CXR sign?

Answer 6

Notching of inferior border of ribs (not seen in young children)

Question 7

What’s a mid systolic murmur also called?

Answer 7

Systolic ejection murmur

Question 8

Management options?

Answer 8

• monitor with echo

- may require stent OR surgical repair

Question 9

% of Turner’s syndrome born with coarctation of the aorta?

Answer 9

5%

Question 10

Associations?

Answer 10

1) Turner’s
2) Bicuspid aortic valve
3) Berry aneurysms
4) Neurofibromatosis

Question 11

Complication if untreated?

Answer 11

blood pressure to carotids will increase –> cerebral aneurysms