Coarctation Of Aorta

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)

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