Coarctation of the aorta

Alternative Names

Symptoms

Symptoms depend on how much blood can flow through the artery. Other heart defects may also play a role. In severe cases, symptoms are seen when the baby is very young. In milder cases, symptoms may not develop until the child has reached adolescence. Symptoms include:

• Dizziness or fainting
• Shortness of breath
• Pounding headache
• Chest pain
• Cold feet or legs
• Nosebleed
• Leg cramps with exercise
• Hypertension (high blood pressure) with exercise
• Decreased ability to exercise
• Failure to thrive
• Poor growth

Note: There may be no symptoms.

Exams and Tests

The health care provider will perform a physical exam and take your blood pressure in your arms and legs. Your pulse will be checked. The pulse in the femoral (groin) area is weaker than the carotid (neck) pulse. Sometimes, the femoral pulse may not be felt at all.

The doctor will use a stethoscope to listen to your heart and check for murmurs. People with aortic coarctation have a harsh-sounding murmur that can be heard from the back. Other types of murmurs may also be present.

Coarctation is often discovered during a newborn's first examination or a well-baby exam. Taking the pulses in an infant is an important part of the examination since there may not be any other symptoms or findings until the child is older.

Tests to diagnose this condition may include:

• Chest x-ray
• ECG
• Echocardiography
• Doppler ultrasound of the aorta
• Chest CT
• MRI of the chest
• Cardiac catheterization and aortography

Both Doppler ultrasound and cardiac catheterization can be used to see if there are any differences in blood pressure in different areas of the aorta.

References

Webb GD, Smallhorn JF, Therrien J, et al. Congenital heart disease. Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007: chap 61.