Coarctation of the Aorta

Question 1

Coarctation of the Aorta is what congenital heart defect?

Answer 1

Obstructive Disorder

Question 2

Pathophysiology of Coarctation of the Aorta

Answer 2

1. The narrowing of the aorta
2. As a result of the narrowing, blood flow is impeded, causing BP to increase in the heart and upper extremities and decreased BP in the lower extremities

Question 3

Signs and Symptoms

Answer 3

• Irritability
• Frequent epistaxis
• Leg pains with activity
• Dizziness
• Fainting
• Headache
• Bounding pulse (upper extremities)
• Weak or Absent pulses (lower extremities)
• Notching of rib (in school-age children)
• Soft or moderately loud systolic murmur (heard at the base of the heart; left axilla or on the back)
• Syncope

Question 4

Nursing Assessment: Health History and Physical Examination

Answer 4

1. Note problems with irritability and frequent nosebleeds
2. In older children, reports of leg pain with activity, dizziness, fainting and headache
3. Note bounding pulses in upper extremities and weak/absent pulses in the lower extremities
4. Note school-age child’s chest noting notching of the ribs
5. Auscultate the heart for a soft or moderately loud systolic murmur (heard at the base of the heart, left axilla and on the back)

Question 5

Diagnostic Testing

Answer 5

• Diagnosis is based on the history and physical exam

1. Echocardiogram
2. Chest radiography (notching of the ribs and cardiac enlargement)
3. Electrocardiogram
4. MRI
5. CT

Question 6

Potential Complications

Answer 6

• Collateral circulation
• Aortic rupture
• Aortic aneurysm
• Heart Failure
• Stroke (cerebral vascular accident)