Coarctation of the Aorta Flashcards
Where may coarctation take place
typically wither just distal to the left subclavian artery or between the left common carotid/ left subclavian
in theory could be anywhere
Symptoms of Coaractation
Intermittent claudication
Chest pain
heart failure
HTN
Endarteritis
Features of Turners syndrome
45XO karyotype
Female
Short stature
Webbed neck
Cubitus valgus
Nipple hypoplasia
hyperteiosm
lack of pubic hair
lack of secondary sexual characteristics
bicuspid aortic valve
Coarctation of aorta
Features of coarctation (not auscultation)
Radial radial volume difference
Radio-femoral delay
BP difference between each arm
Displaced heaving apex
Lt lateral thoracotomy (if surgically repaired)
Underdeveloped lower half of body
Auscultation of coarctation of the aorta
ESM in aortic area (coactation/ bicuspid AV). could progress into diastole if severe
May get EDM (AR) of bicuspid AV
may radiate into thoracic spine
Associated conditions with coarctation
Bicuspid AV
Turners
VSD
MV prolapse
PDA
Aortic dissection
Neurofibromatosis 1
marfans syndorme
SAH
Shones syndrome
ECG of coarctation
LVH with LBBB
CXR of Coarctation
Rib notching
3 shaped descending aorta
Investigation of coarctation
ECG
CXR
TTE/TOE (identify the coarctation + affect on heart)
Cardiac MRI (anatomy)
Cardiac Catheterisation (coronary artery pre op as may need CABG)
What are patient with coarctation at risk of?
early ischaemic heart disease
Surgical management of coarctation
Endovascular aortic repair (EVAR)
Decron patch aortoplasty
Who requires surgical intervention?
symptomatic with gradient across >30mmHG
asymptomatic with LVH/HTN
What should coarctation patients avoid
strenuous exercise/ weight lifting due to risk of dissection
