Coarctation Of Aorta

N C Joshi
Consultant Pediatrician, Nanavati Hospital, Mumbai, India
First Created: 01/24/2001 

Introduction

  • Seen in 30% of Turner's Syndrome

  • M:F=2:1

  • >50% have bicuspid aortic valve

Coarctation of Aorta - Types

  • Preductal: associated with other defects (40%)

  • Postductal

Coarctation of Aorta - Clinical Manifestations

  • Asymptomatic in majority

  • CHF in severe cases

Physical Examination:

  • PULSE: absent, weak or delayed in the legs

  • Hypertension in the arms

  • Mid-systolic ejection murmur at LLSB and back (right)

Figure 1: Cardiac findings of coarctation of the aorta. A systolic thrill may be present in the Suprasternal notch (area shown by the dots)


Cardiac findings of coarctation of the aorta

Coarctation of Aorta - Investigations

ECG

  • newborn: RVH

  • older child: normal or LVH

Chest X-ray

  • "3 sign" on overpenetrated film

  • rib notching

Coarctation of Aorta - Treatment

Surgical - resection of Coarctation of aorta (4-5 years)

  • End-to-end anastomosis

  • Patch grafts

  • Left subclavical artery as a patch

Coarctation of Aorta - Complications

  • Spinal cord ischemia

  • Post-coarctectomy syndrome


Coarctation of Aorta Coarctation of Aorta Coarctation of Aorta 01/24/2001
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