Coarctation of the aorta is a constriction of the aorta artery due to a congenital defect, preventing the free flow of blood and sometimes causing the heart to abnormally enlarge. The aorta is the main blood vessel that carries oxygen-rich blood from the heart to the rest of the body. The aorta narrows at a point just next to the aortic arch where the ductus arteriosus inserts. The ductus arteriosus is a blood vessel that is normally present in a fetus and has special tissue in its wall that causes it to close in the first hours or days of life. Some children born with coarctation of the aorta have other heart defects, too, such as aortic stenosis, ventricular septal defect, patent ductus arteriosus or mitral valve abnormalities.
With mild coarctation, symptoms may be absent. In more severe coarctation, symptoms may include difficulty breathing, poor appetite or trouble feeding, failure to thrive. Later on, children may develop symptoms related to problems with blood flow and an enlarged heart. They may experience dizziness or shortness of breath, faint or near-fainting episodes, chest pain, abnormal tiredness or fatigue, headaches, or nosebleeds. They may have cold legs and feet or have pain in their legs with exercise.
Although treatment is conservative if asymptomatic, it may require surgical resection of the narrow segment if there is arterial hypertension. The first operations to treat coarctation were carried out by Clarence Crafoord in Sweden in 1944. In some cases angioplasty can be performed to dilate the narrowed artery. If the coarctation is left untreated, arterial hypertension may become permanent due to irreversible changes in some organs, such as the kidney.
Coarctation of the Aorta (Video)