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Coarctation
What is it?
There is a narrowed area in the major blood vessel that
brings blood from the heart to the body (aorta). This
narrowing can be a shelf of tissue, a long segment of
narrowing, or a twisted area of the aorta. This common heart
defect may be found at any age, depending upon how severe
the narrowing. The blood pressure is elevated in the part of
the aorta above the narrowing and is normal or lower below
it. For that reason, the arm blood pressure is high and the
leg blood pressure is lower (they should be about the same).
How is it recognized?
The diagnosis may be made at any age, depending on the
severity of the narrowing. Poor or absent pulses in the legs
or high blood pressure in the arm with lower leg blood
pressure with a heart murmur may indicate that a coarctation
may be present.How is it evaluated?
A pediatric cardiologist needs to evaluate your child.
Besides a physical examination, an EKG and probably an
echocardiogram will help the cardiologist diagnose the
problem. In some cases, an MRI or a cardiac catheterization
test may be needed to define the exact location and anatomy
of the narrowing in order to determine the best treatment.
What needs to be done?
Surgery may be recommended, with the timing dependent on the
severity of the narrowing. If a cardiac catheterization test
is needed, it may be possible to open or dilate the narrowed
area using a special balloon catheter (Balloon Angioplasty)
or a stent at the same time. If the narrowed area of the
aorta cannot be opened with a balloon angioplasty or a stent,
then surgery will be needed in order to open the constricted
area. Your child’s cardiologist will discuss the options
with you regarding your child’s specific problem.
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