children s health issues
Coarctation of the Aorta
Introduction
Coarctation of the aorta is a narrowing of part of the aorta, the main blood vessel bringing red oxygenated blood from the heart to the body. The aorta narrows, causing the heart to pump harder to push blood through the narrowed aorta to get adequate blood flow to the lower half of the body. Infants with severe coarctation become suddenly ill when they are a few days old, showing signs of heart failure and decreased blood flow to the lower body. Older children with coarctation often have no symptoms. The diagnosis is suspected based on symptoms and findings during a doctor's examination and is confirmed with echocardiography. Most children with coarctation need corrective surgery or balloon angioplasty to widen the narrowed aorta. (See also Overview of Heart Defects .) Coarctation, a heart birth defect, is narrowing of just one segment of the aorta, not the whole aorta. The narrowing is typically located across from the point where the ductus arteriosus joins the aorta. The ductus arteriosus is a blood vessel connecting the two great arteries leaving the heart, the pulmonary artery and the aorta (see Normal Fetal Circulation ). In the womb and during the first few days of life, the ductus is open, so blood flowing through it bypasses the narrowed section of aorta. Coarctation may reduce blood flow to the lower half of the body, including the kidneys, liver, and other organs in the abdomen. The blood pressure is lower than normal in the legs and tends to be higher than normal in the arms. Coarctation is a serious but treatable cause of High Blood Pressure . A heart murmur (a sound created by turbulent blood flow through narrowed or leaking heart valves or through abnormal heart structures) is sometimes present. Without treatment, severe coarctation can be fatal in newborns. Less severe coarctation eventually strains and enlarges the heart and causes high blood pressure. Coarctation makes the child susceptible to heart infection ( Infective Endocarditis ) and bleeding in the brain. Children with coarctation often have other heart defects, such as 