Pathoma- Congenital Defects

Question 1

What embryonic structure is infantile coarctation of aorta associated with

Answer 1

PDA

Question 2

Where does infantile coarctation of aorta usually develop

Answer 2

After (distal to) aortic arch, but before (proximal to) PDA

Question 3

What physical finding is associated with infantile coarctation and why?

Answer 3

Cyanosis of lower extremities at birth. This is bc the coarctation acts as an obstruction and makes the aorta ditsal to it low pressure. As a result, the deoxygenated blood in pulmonary trunk will use PDA to go into the distal aorta, and the loewr extremities will be fed deoxygenated blood.

Question 4

What syndrome is associated with infantile coarctation of aorta?

Answer 4

Turner’s syndrome

Question 5

Where is the adult form of coarctation usually located?

Answer 5

After (distal to) aortic arch

Question 6

What physical exam finding is associated with adult form of aortic coarctation and why?

Answer 6

HTN in the upper extremities and hypotension with weak pulses in the lower extremities. This is because the coarctation partially blocks blood flow to the distal aorta where branches for the loewr body come off. As a result, the upper extremities get lots of blood (HTN) while the loewr extremities get less blood (hypotension + weak pulses).

Question 7

What classic finding on x-ray is found in pts with adult form coarctation and why?

Answer 7

“Notching of ribs” on x-ray. This is because collateral circulation develops to get to the distal aorta by using the intercostal arteries. As a result, the intercostal arteries engorge and press on the intercostal bones, producing the notching.

Question 8

What is associated with adult form coarctation?

Answer 8

Bicuspid aortic valve