Reviewed by Brian R. Robinson, MDCoarctation of the aorta is a congenital heart disorder where the aorta is abnormally narrow. This defect forces the left ventricle to work harder, which can lead to heart failure.
In a healthy heart, the left atrium fills with oxygenated blood from the lungs, and then passes it to the left ventricle. Pumped by the left ventricle, the blood then travels through the aorta to the rest of the body. Several arteries branch off the aorta to take blood to the head and arms. Then the aorta takes blood toward the legs and abdomen. Coarctation generally occurs after the aorta has branched to bring blood to the upper body, but before it has brought the blood toward the lower body. Some of the blocked blood thus is rerouted towards the upper body. This leads to high blood pressure in the arms and head, and low blood pressure in the legs and abdomen. Coarctation forces the left ventricle to work harder than usual to pump blood throughout the body. This can, over time, lead to heart failure. Fifty percent of infants with coarctation will develop symptoms of heart failure, such as shortness of breath and pale skin, in the first few days or weeks of life. If these symptoms develop, it is important to see a doctor immediately.
If the infant does not exhibit symptoms, the doctor will probably detect it when he or she hears a heart murmur, weak pulses in the legs, or high blood pressure in the arms during a routine examination. Echocardiography is most common to confirm the diagnosis, but in some cases an MRI or CT scan is used.
Medication can treat the symptoms, but surgery is the only cure. Balloon dilation and stents are minimally invasive, but they are only options in a few cases. Usually the operation requires a more involved reconstruction of the aorta. This type of procedure is usually performed when the child is between 3-5 years old. In the meantime, medications are used to control symptoms.
