A coarctation of the aorta is diagnosed when a portion of the aorta is narrowed making it difficult for blood to pass through the major artery. The aorta is responsible for moving blood out of the heart to the blood vessels that disperse nutrients and blood to all parts of the body.
Coarctation of the aorta may be associated with genetic disorders like Turner syndrome. The condition may present in combination with other heart disorders such as patent ductus arteriosus, bicuspid aortic valve, mitral valve stenosis or aortic valve stenosis.
Symptoms of coarctation of the aorta depend on the extent of the narrowing. In mild cases, symptoms may not develop until adulthood, though the majority of conditions are diagnosed before age 40. Symptoms may include:
- Trouble breathing
- Irritable nature
- Paled skin
- Increased blood pressure
- Weakness in muscles
- Cramps in legs
- Cold feet
- Chest pains
Complications associated with coarctation of the aorta include hypertension, stroke, rupturing of the aorta, coronary artery disease, cerebral aneurysm, organ failure, and death. Many complications are associated with prolonged hypertension. After surgical repair of the aorta is complete, patients are at increased risk of re-narrowing and aortic rupture.
Pregnancy in later life poses risk for female patients with coarctation of the aorta. Increased blood volume places pressure on the repaired portion of the aorta increasing the risk of aortic rupture. Pregnancy risks should be weighed with the gynecologist and cardiac specialist before attempting to conceive.
Testing and Diagnosis
Coarctation of the aorta may go unnoticed during yearly well visits unless the doctor detects hypertension, variations in blood pressure between arms and legs, weakened pulse in the legs or a heart murmur. Diagnostic tests may include:
- ECG or EKG – Electrocardiogram
- MRI – Magnetic resonance imaging
- CT angiogram – computed tomography angiogram
- Catheterization of the heart
In most cases, coarctation of the aorta is treated with surgery to repair the narrowed portion. The repair can take place in infancy and is usually performed before age 10. Adults may need subsequent repair surgeries if the narrowing returns. High blood pressure is common even after the aortal repair is complete. Patients may need to take medications to reduce blood pressure.
If coarctation of the aorta is treated early, the prognosis is good with continued care and treatment. Many patients left untreated have a shortened lifespan of fewer than 40 years due to complications of the birth defect.