Coarctation of the aorta (COA) is a heart defect that is present at birth (congenital). It means the aorta is narrower than it should be. The aorta is the large artery that carries oxygen-rich (red) blood from the left ventricle to the body. This narrowing means that less oxygen-rich blood is sent to the body.
The amount of narrowing can vary. A child with greater narrowing of the aorta will have more symptoms. The symptoms will also be seen at an early age. In some cases, coarctation is seen in infancy. In others, it may not be seen until school-age or teenage years. COA may be diagnosed in infants, school-age children, or teens. It is more commonly seen in males. There is an increased chance of having the condition if another family member has it. It also occurs more often in certain genetic syndromes such as Turner Syndrome.Coarctation of the aorta is usually associated with other cardiac defects, with a bicuspid aortic valve being a commonly associated defect.
These are the most common symptoms of coarctation of the aorta:
Mild narrowing may not cause symptoms at all. The healthcare provider may find high blood pressure. Or he or she may hear an abnormal sound (heart murmur) when listening to your child's heart with a stethoscope. Adults with the condition are at increased risk of intracranial aneurysms. This is a weakening and ballooning of blood vessels in the brain. This is especially the case if they have high blood pressure.The symptoms of COA can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. The provider may refer you to a pediatric cardiologist is a doctor with special training to treat heart problems in children. The cardiologist will examine your child and listen to his or her heart and lungs. Your child may also have tests such as:
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
COA is treated by fixing the narrowed vessel. It may be fixed by:
If untreated, COA causes several problems:
All children with COA will need to have the defect fixed. Some infants will be very sick and need care in the intensive care unit before the procedure. In some cases, a child may need emergency repair. Children who have few symptoms will have scheduled repairs. Most children who have had a COA repair will live healthy lives. Activity levels, appetite, and growth should return to normal in time.
After the repair, your child's cardiologist may recommend your child take antibiotics before surgeries or procedures, such as dental work. This is done to prevent infection.
As the child grows, the aorta may again become narrow. If this happens, another balloon procedure or surgery may be done.
Controlling blood pressure is very important. Your child's blood pressure may be higher after aortic coarctation repair. He or she may need to take medicines to help lower blood pressure.
Your child will need regular follow-up care at a center offering pediatric or adult congenital cardiac care throughout life.
Tips to help you get the most from a visit to your child’s healthcare provider: