Aortic coarctation history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S.[2], Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S.[4]

Overview

The signs and symptoms of coarctation of the aorta depend on how much blood can flow through the artery. Children with serious aortic narrowing tend to show signs and symptoms earlier in life, while mild cases may not be diagnosed until adulthood. Common symptoms include dizziness, syncope, dyspnea, and hypertension.

History and Symptoms

  • Symptoms can vary significantly depending on the hemodynamics of the heart. The amount of blood flowing through the artery directly impacts the coarctation site as this may caused pressure and rate of flow differentials. Additionally, the presence of other heart defects or a history of any associated heart defects can also influence the flow of blood in the heart and result in different symptoms.
  • It usually doesn't cause any hemodynamic complications in utero because most of the blood (approximately 90%) flows through the PDA into the descending thoracic aorta, bypassing the isthmus (where the coarctation is usually located).
  • However, once the patent foramen ovale and ductus arteriosus closes after birth, the neonate might start showing symptoms as the the entire cardiac output to the lower extremity now cross the narrowed aortic segment.
  • In general, 50% of newborns symptoms will develop symptoms within the first few days of life. Children with serious aortic narrowing tend to show signs and symptoms earlier in life. In milder cases symptoms may not appear until adolescence. Some people may show no symptoms at all. 80% of all aortic coarctations are diagnosed during a patient's infancy and early childhood.
  • The commonest location of coarctation is just distal to the left subclavian artery. Less often, it may occur just proximal to the left subclavian artery. The earlier classification of coarctation based on its location relative to patent ductus arteriosus is confusing and thus should be avoided.

Common symptoms include:

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