Overview, Causes, & Risk Factors
The aorta is the main artery of the body and carries blood away
from the heart. Coarctation is an abnormal narrowing in the
aorta that is present at birth, causing congenital heart disease.
What is going on in the body?
It is not known why coarctation of the aorta occurs. The
narrowing in the aorta decreases the amount of blood that can flow through it.
The worse the narrowing, the worse the symptoms. Severe cases may lead to
early symptoms in infancy. Milder cases may not be discovered until adulthood.
What are the causes and risks of the condition?
The cause of coarctation of the aorta is unknown. Those who
are at higher risk for this condition include:
males, who are more commonly affected than females
those with Turner syndrome,
a condition present at birth that affects only females and is caused by an
abnormal number of chromosomes
those with other heart defects present at birth, often called
congenital heart disease
Symptoms & Signs
What are the signs and symptoms of the condition?
Symptoms of coarctation of the aorta may be mild or severe.
In severe cases, symptoms usually begin shortly after birth. The main symptoms
are due to congestive heart failure,
as the heart cannot pump blood through the narrowed passage. Congestive heart failure
in children can cause:
a rapid heartbeat
swelling in the abdomen
swelling in the legs
trouble breathing or fast breathing
If symptoms do not occur until later in life, they may include:
high blood pressure
in the arms with low blood pressure
in the legs
symptoms of congestive heart failure,
including swelling of the legs and shortness of breath
an upper body that is stronger and better developed than the lower body
Most of these symptoms tend to get worse with exercise. They
are mostly due to the fact that blood can flow more easily to the upper body,
which is above the narrowed portion of the aorta. The lower body, which is below
the narrowed section of aorta, does not get as good a blood supply, so it does
not grow as well.
Diagnosis & Tests
How is the condition diagnosed?
The diagnosis of coarctation of the aorta may be suspected
from the medical history and physical exam. A heart tracing, called an
and a chest X-ray
are commonly done and may be abnormal. Imaging tests of the heart,
such as a test that uses sound waves called echocardiography,
can confirm the diagnosis. A chest MRI
and chest CT scan
can also show the defect.
An X-ray procedure called cardiac catheterization
may be done in some cases. In this test, a thin tube is inserted through the
skin and into an artery, usually in the groin. The tube is then advanced along
the artery and up into the heart. A contrast agent can then be squirted through
the tube and into the blood. X-ray pictures of the contrast agent can be taken
as it flows through the heart and aorta.
Prevention & Expectations
What can be done to prevent the condition?
There are no known ways to prevent coarctation of the aorta.
What are the long-term effects of the condition?
In severe cases, newborns with coarctation of the aorta can die
without immediate treatment. Long-term effects include:
bleeding into the brain
congestive heart failure
high blood pressure
infections of the heart
rupture or tearing of the aorta, which is called
Adults rarely survive past the age of 40 without treatment
because of these long-term effects. Timely treatment can avoid most of
What are the risks to others?
Coarctation of the aorta is not catching and poses no risks
Treatment & Monitoring
What are the treatments for the condition?
Severely affected infants with coarctation of the aorta may need
surgery shortly after birth. Before surgery, these infants may need aggressive
treatment in the intensive care unit.
This may include powerful medicines and an artificial breathing machine called a
For those with no symptoms at birth, surgery is often advised
later in childhood or in early adulthood when symptoms or heart damage begin.
The goal of surgery is to remove or bypass the narrowed part of the aorta.
What are the side effects of the treatments?
Surgery carries a risk of bleeding, infections,
and even death.
What happens after treatment for the condition?
After recovering from surgery, most people do well. Long-term
follow-up care is needed to watch for or treat high blood pressure,
which is fairly common after surgery. Narrowing in the aorta can recur,
especially in children less than 5 years old. In the absence of high blood
pressure, most people can resume a normal life after recovery.
How is the condition monitored?
Long-term monitoring of blood pressure
is needed. Other monitoring may be needed if heart damage or other heart
defects are present before surgery. Any new or worsening symptoms should
be reported to the doctor.