Recognizing the Problem
Coarctation of the aorta is typically diagnosed in infancy, before symptoms develop. Comparing the pulse felt in an infant's neck and groin often provides the first clue. The pulse will be significantly stronger in the neck than in the groin, because of the location of the narrowing of the aorta branches that send blood to the upper and lower parts of the body. An audible "murmur" can also typically be heard using a stethoscope on the back.
The condition may not produce symptoms, but if it does, they can include:
- Shortness of breath, dizziness or fainting
- Pounding headaches or nosebleeds (due to higher blood pressure above the heart)
- Cold feet or legs, or leg cramping after exercise (due to impaired circulation below the heart)
To diagnose the problem, physicians may use a number of tests, including:
- Doppler ultrasound -- sound waves used to create an image to show disruptions in blood flow
- Cardiac catheterization -- a thin tube delivering dye to blood vessels so they show up more clearly in an x-ray
- MRI -- an image producing a detailed three-dimensional (3-D) image of the area in question
- CT scan -- creates "slice-by-slice" x-ray snapshots, also creating a detailed 3-D image
Treating the Condition
The coarctation may be removed surgically, joining the two free ends together in a procedure called anastomosis. In some cases, it can be repaired with a small balloon, which is inserted through an incision in the groin and fed through the veins to the problem area. The balloon is then inflated and opens the area to an appropriate width.
Even after this correction, the problem can return. In such cases, the procedure can be repeated. If a patient whose coarctation was repaired in childhood or infancy reaches adulthood without noticeable differences in upper- and lower-body pulses, recurrence is highly unlikely.
Outlook for People With This Problem
Without correction, most people with coarctation of the aorta die before age 40. Repair of the coarctation is recommended before age 10 and preferably in infancy.
Patients with a repaired coarctation should continue regular checkups with a cardiologist. Even if the aorta doesn't narrow again, high blood pressure can occur.
Individuals with a repaired coarctation may also need to restrict their physical activity, especially repeated heavy lifting. Women with the condition who plan to become pregnant should consult a cardiologist to determine if they can tolerate the strain of pregnancy.
Sources:
"Coarctation of the Aorta." americanheart.org. 2008. American Heart Association. 14 Sep. 2008 <http://www.americanheart.org/presenter.jhtml?identifier=11069>.
"Coarctation of the Aorta." nlm.nih.gov. 11 Dec. 2007. U.S. National Library of Medicine, National Institutes of Health. 14 Sep. 2008 <http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/000191.htm>.
