Coarctation of the Aorta

Question 1

What is Coarctation of the Aorta?

Answer 1

• Coarctation of the Aorta is a congenital condition where there is narrowing of the aortic arch
• Usually around the ductus arteriosus
• The severity can vary from mild to severe
• It is often associated with Turners Syndrome

Question 2

How will a baby with coarctation of the aorta present?

Answer 2

• Four limb blood pressure = high blood pressure in limbs supplied before the narrowing, low blood pressure in limbs supplied after the narrowing
• Systolic murmur = heard below the left clavicle in the infraclavicular area and below left scapula
• Tachypnoea + increased work of breathing
• Poor feeding
• Grey and floppy baby
• Left ventricular heave = left ventricular hypertrophy
• Underdeveloped left arm due to reduced flow to the left subclavian artery
• Underdevelopment of the legs

Question 3

What is the managment for Coarctation of the Aorta?

Answer 3

• Depends on the severity of the coarctation
• In mild cases patients can live symptoms free until adulthood
  Severe cases:
  1. Prostaglandin E to keep the ductus arteriosus open - allowing some blood flow through the ductus arteriosus into the systemic circulation
  2. Surgery to correct the coarctation and ligate the ductus arteriosus