Paeds: Coarctation of the aorta (adult type): Dr Clarke Flashcards
1
Q
Path
A
Acyanotic
Out flow obstruction
Not duct dependent becomes severe over the years
Preductal-
While the PDA is open the right ventricle can maintain cardiac output.
Post ductal
2
Q
Preductal symptoms
A
No murmur while PDA is open.
On closure HF and ESM
3
Q
Post ductal symptoms
A
Symptoms - Baby breathless, grey and collapsed Hepatomegaly Pulses are better n the arms than in the legs BP lower in legs No murmurs? ESM (check)
4
Q
Signs
A
- Systemic HTN in arms esp right arm (lower in legs)
- ESM R sternal edge
- collaterals at the back -Radio-femoral delay (due to blood bypassing the obstruction via collaterals in the chest)
5
Q
CXR
A
-rib notching (collateral intercostal arteries) -‘3’sign- notch in the descending aorta
6
Q
ECG
A
LVH
7
Q
Echo
A
Anatomy
8
Q
Rx pre-ductal
A
Prostaglandin to keep PDA open while awaiting surgery.
Control HF prior to surgery
9
Q
Post-ductal Rx
A
Stent through coarctation via cardiac catheter or surgery and ligation of PDA
