Coarctation of the Aorta

Coarctation of the aorta is a narrowing of the inside the aorta, the major artery leading from the heart. This defect makes up between seven and eight percent of all heart defects that are present from birth.

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Symptoms

Babies with this defect may have:

  • Sudden heart failure
  • A major rise in the acid level of the blood and tissues as the flow of blood to far parts of the body is impaired. This type of imbalance is marked by sickly sweet smelling breath and vomiting.

Older children may have:

  • High blood pressure in general or high blood pressure in the arms compared to the legs
  • A soft sound heard in the lungs, usually louder in the back. This often occurs over where the defect is.
  • Pulses in the legs can be felt but are softer and delayed compared with those in the arms.
  • Increased blood flow through the arteries of the chest visible on X-rays. This usually doesn't appear before the child is 10 to 12 years old.
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Diagnosis

An electrocardiogram (a test that shows the electrical activity of the heart during a heart beat) usually looks normal. An X-ray from certain angles can show the defect.

Other tests such as cardiac catheterization or angiography are usually not needed. An exception is if other significant defects are also present or if the narrow segment is unusually long or the aorta is not in a typical location.

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Treatments

Babies are treated immediately with drugs to improve blood flow. This allows for surgery to repair the condition.

In children between the ages of four and six, surgery to repair the defect is recommended. Surgery should be done sooner if the child has high blood pressure in the arms, heart failure or other complications. Efforts should be made to prevent infections in the heart.

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