Coarctation of Aorta 

Introduction

Coarctation of the aorta is the narrowing of the aorta where the ductus arteriosus (ligamentum arteriosum after regression) inserts 

Preductal: identified in infancy; early presentation of symptoms 

Postductal: identified in early adulthood; later presentation of symptoms 

-Most common site of coarctation is distal to the left subclavian artery

-Poses high risk for aortic aneurysm, dissection, rupture, CHF, stroke 

-Associations: Turner’s syndrome, Berry aneurysms, Bicuspid aortic valve 

Symptoms &  Signs 

Infants: pale skin, difficulty feeding, difficulty breathing, irritability 

Adults: Exertional dyspnea, headache, epistaxis and leg fatigue, 

-Hypertension in the arms, with low or normal pressure in the legs 

-Absent or weak and delayed femoral pulsations in comparison with the brachial or radial pulse 

-A continuous murmur loudest at left infrascapular region, posterior inter scapular area, 

-Lower blood pressure in the legs than in the arm

-Cyanosis in lower half of the body 

Diagnosis 

Radiography 

Rib notching: scalloping of the inferior portion of the ribs due to enlarged intercostal arteries 

3 sign: aortic arch and dilated left subclavian artery forming the upper curvature and poststenotic dilation of the descending aorta forming the lower

ECG: left ventricular hypertrophy, left atrial enlargement 

Echocardiography, CT, MRI

Treatment 

balloon angioplasty, Endovascular stenting, or surgery 

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