Coarctation of the aorta (or aortic narrowing) is a congenital narrowing of part of the aorta (the major artery that branches off your heart and delivers oxygen-rich blood to the body). The narrowing may occur in any part of the aorta, but mostly is localized just below the exit of the left artery subclavia. When a patient has a coarctation, their heart must pump harder to force blood through the narrow part of the aorta, which causes high blood pressure before point of coarctation and low blood pressure beyond point of coarctation.
Symptoms depend on how much the artery is narrowed and also depend on the other heart defects. The newborns with the severe coarctation will have symptoms like: pale skin, breathing fast, problems eating, increased irritability and sleepiness in the first few days of life. Untreated aortic coarctation in babies may lead to heart failure and death.
Older children and adults with less severe narrowing of the aorta often don’t have symptoms or if they appear the most common will be:
- High blood pressure
- Chest pain
- Cold feet or legs
- Dizziness or fainting
- Decreased ability to exercise
- Failure to thrive
- Leg cramps with exercise
- Poor growth
- Pounding headache
- Shortness of breath
Coarctation of the aorta can remain asymptomatic for a long time.
The exact cause of coarctation of the aorta is unknown. The abnormalities in development of the aorta generally begin before birth. Aortic coarctation is more common in persons with certain genetic disorders, such as Turner syndrome and often occurs along with other heart defects, such as:
- Bicuspid aortic valve
- Defects in which only one ventricle is present
- Ventricular septal defect
Rarely, coarctation of the aorta may develop later in life. Traumatic injury, severe hardening of the arteries (atherosclerosis) or a condition causing inflamed arteries (Takayasu's arteritis) may narrow the aorta, leading to aortic coarctation.
Coarctation of the aorta often occurs along with other congenital heart defects. If the patient has any of the following heart conditions: bicuspid aortic valve,patent ductus arteriosus,aortic valve stenosis or mitral valve stenosis, is more likely to have aortic coarctation as well.
Complications that may occur before, during, or soon after surgery include:
- Aortic aneurysm
- Aortic dissection
- Aortic rupture
- Bleeding in the brain
- Early development of coronary artery disease (CAD)
- Endocarditis (infection in the heart)
- Heart failure
- Kidney problems
- Paralysis of the lower half of the body (a rare complication of surgery to repair coarctation)
- Severe high blood pressure
Long-term complications include:
- Continued or repeated narrowing of the aorta
- High blood pressure
Unfortunately, there is no known way to prevent this disorder because it’s congenital. However, the early detection and treatment is the most important for patients who are affected by coarctations.