Coarctation Of The Aorta Flashcards
What is coarctation of the aorta?
It is defined as a congenital condition in which there is narrowing of the aortic arch, usually around the ductus arteriosus
What class of congential heart disease is coarctation of the aorta?
Acyanotic
What is the pathophysiological consequence of coarctation of the aorta?
The narrowed aorta results in an obstruction of blood flow through the left ventricles
This leads to an increase in left ventricular afterload, and therefore left ventricular hypertrophy
What five risk factors are associated with coarctation of the aorta?
Male Gender
Turner’s Syndrome
Bicuspid Aortic Valve
Berry Aneurysms
Neurofibromatosis
What is the most common risk factor associated with corrctation of the aorta?
Turner’s Syndrome
When does coarctation of the aorta tend to present?
In moderate to severe disease, it presents 3 -5 days after birth
In mild disease, it can present later on in adulthood
What are the ten clincial features of coarctation of the aorta?
Cold Extremities
Feeding Difficulties
Tachycardia
Tachypnoea
Refractory Hypertension
Mid-Systolic Murmur
Radio-Femoral Delay
Weak Femoral Pulses
Left Ventricular Heave
Hepatomegaly
Describe the systolic murmur associated with coarctation of the aorta
It is loudest heard on the back at the scapula region and the left infraclavicular area
What three investigations are used to diagnose coarctation of the aorta?
Four Limb Blood Pressure Test
Chest X-Ray (CXR)
ECHO Scans
What four limb blood pressure test result indicates coarctation of the aorta?
There is a high blood pressure in the limbs supplied from arteries, which originate before the narrowing
AND
There is a low blood pressure in the limbs supplied from arteries, which originate after the narrowing
What is a feature of coarctation of the aorta on CXR?
Inferior border rib notching
How is inferior border rib notching associated with coarctation of the aorta?
The aortic obstruction results in development of dilated intercostal vessels, in order to allow sufficient blood flow to reach the descending aorta
The pressure of these vessels erode the inferior margins of the ribs
What is the gold standard investigation used to diagnose coarctation of the aorta?
ECHO Scans
What are the two features of coarctation of the aorta on ECHO scans?
Narrowed Descending Aorta Lumen
Left Ventricular Hypertrophy
What are the two pharmacological management options of coarctation of the aorta?
IV Prostaglandin E1
Beta-1 Agonists
