Aortic coarctation is a congenital heart defect marked by the narrowing of the aorta, typically near the ductus arteriosus just past the branches supplying the upper body. This narrowing obstructs normal blood flow, increasing pressure in arteries supplying the head and upper limbs while reducing blood supply to the lower body. Though its cause is not fully understood, it is often associated with other congenital conditions like bicuspid aortic valve or Turner syndrome.
The severity of coarctation varies. In neonates with severe narrowing, symptoms can emerge within days of birth, especially after the ductus arteriosus closes. These may include rapid breathing, feeding difficulties, weak pulses in the lower extremities, and signs of heart failure. In contrast, milder cases may go undetected until adolescence or adulthood, when symptoms like hypertension, frequent headaches, chest pain, or leg fatigue during exercise appear.
Diagnosis begins with clinical signs such as differences in blood pressure between upper and lower limbs or heart murmurs. Definitive diagnosis involves imaging modalities like echocardiography for infants and MRI or CT angiography for detailed anatomical evaluation in older patients.
Treatment has advanced significantly. In infants and young children, surgical resection of the narrowed segment remains standard. However, less invasive methods such as balloon angioplasty—often with stent placement—are increasingly used, especially in older children and adults. Recent studies show improved long-term outcomes with early detection and tailored interventions, reducing risks of persistent hypertension and cardiovascular complications.
Without treatment, aortic coarctation can lead to life-threatening conditions, including aortic dissection, stroke, or premature heart failure. Lifelong follow-up is essential due to the risk of re-narrowing and related cardiovascular issues. With timely management, most patients can lead healthy, active lives.
Aortic Coarctation: Causes and Symptoms
