The aorta is the main artery that carries blood from the heart to the rest of the body. Aortic coarctation is a congenital condition in which the aorta narrows or constricts.
This blockage often forces the heart to work harder to pump blood through the narrowed section.
If left untreated, aortic coarctation can lead to high blood pressure, heart failure, stroke, and other complications. This is due to the increased strain on the heart and the disrupted blood flow.
The condition accounts for 5% to 7% of all congenital heart diseases, affecting approximately three to four in 10,000 people in the United States. That’s according to the American Heart Association.
Here’s what to know about diagnosing and treating aortic coarctation.
What Is Aortic Coarctation?
Aortic coarctation is a narrowing of the aorta. This makes it difficult for blood to travel from the heart to the rest of the body.
This narrowing typically happens just beyond the left subclavian artery, which supplies blood to the left arm.
It’s often present at birth and diagnosed in children or adults under 40 years old. Though severe cases often arise in the first few weeks of life, less severe cases can go undetected for years.
The condition, if untreated, can lead to high blood pressure, heart damage, or heart failure.
Causes
In most cases, the exact cause is unknown. That’s according to the American Heart Association.
It’s usually a congenital heart defect that’s present at birth. Some people may have other heart defects at birth in addition to coarctation. Still, it isn’t always diagnosed and treated right away.
Environmental factors sometimes play a role in the development of congenital heart defects.
For example, the child of a parent who has diabetes, uses recreational drugs, or contracts rubella while pregnant has a higher risk of congenital heart issues.
If properly diagnosed and treated, many people with aortic coarctation can live healthy, active lives.
Diagnosing Aortic Coarctation
Doctors often diagnose aorta coarctation using a combination of tests, including:
- Cardiac catheterization — A thin, flexible tube enters through a blood vessel in the groin and reaches into the heart. X-ray images then examine the area for problems.
- Chest x-ray — An imaging test that creates pictures of the organs and structures in the chest.
- Computerized tomography (CT) — A scan that makes detailed pictures of the aorta to show where it’s narrowing.
- Echocardiogram — An ultrasound of the heart showing the location and severity of the artery’s narrowing, alongside other possible heart defects.
- Electrocardiogram — Electrodes that attach to the chest to record to measure the heart’s electrical activity.
- Magnetic resonance imaging (MRI) — Takes detailed pictures of the heart and aorta to show the location and size of the artery’s narrowing.
Treating Aortic Coarctation
The most common treatment for aortic coarctation is surgery.
The best treatment depends on the person’s age, overall health, and the complexity of the heart defect.
Treatment can begin at any age and should happen upon diagnosis, depending on its severity.
A surgeon may remove the narrowed segment of the aorta and rejoin the two ends. They may also sew a patch over the narrowed section using part of the blood vessel to the arm.
Cardiac catheter balloon dilation and stent placement are also common treatments for older children and adults with aortic coarctation.
Signs of Aortic Coarctation
The signs of aortic coarctation can vary depending on a person’s age and the severity of the condition.
In infants with aortic coarctation, symptoms at birth are uncommon. However, signs can develop as early as the first week of life.
In infants and young children, signs may include:
- Cold hands or feet.
- Difficulty breathing or rapid breathing.
- Fast pulse.
- Fatigue.
- Gray or pale skin.
- Heavy sweating.
- High blood pressure in the upper body.
- Irritability.
- Poor feeding or weight problems.
In older children and adults, the most common symptoms are high blood pressure, cold feet, and leg cramps. Other signs include:
- Chest pain during physical activity.
- Fatigue.
- Headaches or nosebleeds.
- Heart murmurs.
- Kidney problems.
- Low blood pressure in the lower body.
- Shortness of breath.
- Weak pulses in the legs.
Talk to your doctor to learn more about heart defects, risk factors, and tips for keeping your heart healthy.
Treating Heart Defects at the UPMC Heart and Vascular Institute
The Center for Aortic Disease at the UPMC Heart and Vascular Institute provides expert treatment of aortic disease with the latest techniques. This includes treating aortic coarctation.
To request an appointment, contact the UPMC Heart and Vascular Institute at 1-844-670-1734 or HeartandVascular@upmc.edu or find more information at www.upmc.com/services/heart-vascular.