Coarctation of the aorta

Question 1

What is coarctation of the aorta?

Answer 1

A congenital condition whereby the aorta is narrow, usually in the area where the ductus arteriosus inserts

Coarctation means narrowing

Question 2

Why and how does it occur?

What does coarctation of the aorta cause?

Answer 2

• Due to arterial duct encircling the aorta just at the point of insertion of the duct
• When the duct closes, the aorta constricts, causing severe obstruction to the left ventricular outflow
• This is the commonest cause of collapse due to left outflow obstruction

Question 3

What clinical features of coarctation of the aorta are there? (physical signs)

On 1st day and 2nd day

Answer 3

1st day:

• Examination usually normal (Duct still open)

2nd day:

• Presents with acute circulatory collapse at 2 days when the ductus arteriosus closes:
  
  • A sick baby with severe heart failure
  • Absent femoral pulses
  • Severe metabolic acidosis
  • Murmer may be heard at the ULSE

Question 4

What are associations with coaractation of the aorta?

Answer 4

Bicuspid AV

VSD

Turners syndrome

Question 5

What is bicuspid AV?

How common?

Answer 5

Bicuspid aortic valve = congential condition where 2 aortic valvelets have fused together to give biscupid valve

Very common 1-2% of population

Question 6

What is the management of coarctation of the aorta?

Answer 6

• Prostaglandins to maintain PDA
• Other drugs such as diurectics to maage heart failure
• Angioplasty with or without stenting to correct area
• Sometimes open heart surgery is needed