Coarctation of the aorta

BY Bhumiphat Srivaranon, Chate Therdkiet, Shinnisha Chulapongwanic

EDITED BY Jittanan Tirawatthanaprapha, Pich Paholpak

What is Coarctation of the Aorta?

Coarctation of the aorta is a congenital heart defect, it is characterized by the odd structure of the Aorta which is narrower than usual. The defect ranges from having no effect to life threatening. Serious cases (Aorta narrowing is severe) are recommended to be treated right away sinceharm such as extremely high blood pressure and heart failure can happen due to the abnormal structure of the vessel.

Risk factors

1. Family history: Those who have a close family member with coarctation of the aorta are more likely to get the ailment themselves.

2. Genetic conditions: Those with specific genetic conditions, such as Turner syndrome or bicuspid aortic valve, are more likely to have coarctation of the aorta.

3. Maternal health: Infants born from pregnant women who smoke, consume alcohol, or use particular drugs or pharmaceuticals may have coarctation of the aorta because these products disrupt development of the fetal in various aspects including the heart.

4. Other congenital heart defects: Those with additional congenital cardiac problems are more likely to get coarctation of the aorta.

Causes and symptoms

The cause of Aortic Coarctation is due to improper formation of the vascular system during pregnancy. The Coarctation of aorta can affect any part of the system but it is often occurs near a blood vessel called ductus arteriosus, because this specific vessel will narrow down to a ligament

(ligamentum arteriosum) during its embryological development. a failed closure of itself will most likely result in defects., It is rare that this congenital condition will develop later in life, but there are more situations that could cause the aorta to narrow

For example

1.) Serious injuries

2.) Hardening of the vessels(atherosclerosis)

- which could cause by a lot of excess body fat

3.) Takayasu arteritis(inflamed arteries)

Symptoms depend on how much the aorta is narrowing down.

Most individuals don’t have any symptoms. A mild coarctation cannot be diagnosed until adulthood b

Symptoms of serious Coarctation of the aorta in infants including

• Difficulty breathing

• Difficulty feeding

• Heavy sweating

• Irritability

• Pale skin

Symptoms of serious Coarctation of the aorta in after infancy including

• Chest pain

• Headaches

• High blood pressure

• Cold feet

• Muscle weakness

• Nose bleed

Treatment

Coarctation of the aorta can be approached using several treatment methods including medication, balloon angioplasty, surgical repair, and subclavian flap repair. Medication plays a crucial role in improving the condition. It helps stabilize the patient's condition before and after surgery by opening the blood vessels.

Balloon angioplasty is an alternative to surgery for older children and adults with aortic constriction. During this procedure, a deflated balloon is inserted into the narrowed area of the aorta. By inflating the balloon, the narrowed segment is widened, improving blood flow and facilitating better circulation.

Surgical repair is the most commonly used treatment method, particularly for infants and young children. It involves open-heart surgery to remove the narrowed portion of the aorta. The healthy ends of the artery are then joined together, a procedure known as end-to-end anastomosis.

Another surgical technique is subclavian flap repair, which is similar to surgical repair. In this procedure, the narrowed segment of the aorta is removed, and instead of connecting the two ends, a segment of the subclavian artery is used to widen the aorta and restore normal blood flow.

The choice of treatment depends on various factors, including the patient's age and health, the severity of the coarctation, and associated heart defects.

Reference:

“Congenital Heart Defects - Facts about Coarctation of the Aorta.” Centers for Disease Control and Prevention, 2 Feb. 2023, www.cdc.gov/ncbddd/heartdefects/coarctationofaorta.html. Accessed 26 May 2023.

“Coarctation of the Aorta.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 25 June 2022, www.mayoclinic.org/diseases-conditions/coarctation-of-the-aorta/symptoms-causes/syc-20352529#:~:text=Coarctation%20of%20the%20aorta%20is,the%20rest%20of%20the%20body.

“National Center for Biotechnology Information.” Coarctation of the Aorta, National Library of Medicine, www.ncbi.nlm.nih.gov/books/NBK430913/.

“Home.” Coarctation of the Aorta, Cincinnati Childrens, www.cincinnatichildrens.org/health/c/coarctation.

“Coarctation of the Aorta (COA).” Www.Heart.Org, 9 May 2023, www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/coarctation-of-the-aorta-coa.