Coarctation of the aorta is a congenital condition involving a narrow point in the aortic arch, usually near the ductus arteriosus. The severity varies from mild to severe. It may be associated with a genetic condition, particularly Turner’s syndrome.
There is increased pressure proximal to the narrowing and decreased pressure distal to the narrowing.
Presentation
The only indication in a neonate may be weak femoral pulses (part of the routine newborn baby check).
Blood pressure readings from all four limbs show:
- Increased pressure in the limbs supplied by vessels proximal to the narrowing (e.g., arms)
- Reduced pressure in the limbs supplied by vessels distal to the narrowing (e.g., legs)
Coarctation can produce a systolic murmur heard below the left clavicle and left scapula.
Other signs in infancy (depending on the severity):
- Raised respiratory rate
- Increased work of breathing
- Poor feeding
- Heart failure
- Shock
Additional signs may develop over time:
- Left ventricular heave due to left ventricular hypertrophy
- Underdeveloped left arm where there is reduced flow to the left subclavian artery
- Underdevelopment of the legs
Management
Management depends on the severity. Mild cases may not require surgical intervention. Severe cases may require emergency surgery shortly after birth.
Last updated January 2025
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