Aortic coarctation involves the narrowing of the aorta near the aortic arch. Aortic stenosis is where the narrowing occurs within or near the aortic valve. Both involve the narrowing of portions of the aortic artery.
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What is coarctation of the aorta?
The heart works as a pump, moving blood and oxygen throughout the body. The main artery in the heart that facilitates this work is the aorta. With aortic coarctation, the aorta is unusually narrow. This coarctation of the aorta alters pressure in the heart and vascular system, putting strain on the heart. Because the aorta is too narrow, the heart has to work harder than normal to push the blood through.
This condition is often present at birth but may develop later in life in some rare cases. If left untreated, aortic coarctation can lead to life-threatening complications, like brain aneurysms.
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What are aortic coarctation symptoms?
Coarctation of the aorta symptoms present differently depending on how severely narrowed the aorta is. Many people with this condition experience no noticeable symptoms. In cases where the aorta is more significantly restricted, several symptoms can appear.
Extreme cases are often caught shortly after birth. Coarctation of the aorta in infants can have symptoms that include difficulty breathing, heightened irritability, pale skin, and excessive sweating.
Common symptoms in older patients include chest pains, headaches, high blood pressure, poor circulation in the feet and lower legs, and muscle weakness.
Many of these symptoms can result from increased blood pressure and decreased oxygen availability to your body parts. When blood flow is restricted, blood pressure can increase while simultaneously starving your body of oxygen-rich blood. The further these body parts are from your heart, the more likely they are to be affected by restricted blood flow.
Request an appointment with the Mass General Brigham heart specialist team to learn more about diagnosing and treating aortic coarctation.
What are the causes of aortic coarctation?
Causes of coarctation of the aorta are unknown, except that most cases are present at birth. In rare cases, this condition can develop in otherwise healthy individuals later in life, caused by traumas to the heart or vascular system, atherosclerosis (plaque build-up in the artery), or Takayasu arteritis (a condition involving inflammation of the arteries).
In most cases, this condition is a heart defect present at birth. The exact cause of heart defects in infants is unknown, but genetics and environment are believed to play a role.
What are the risk factors for aortic coarctation?
As a congenital disability, it can be challenging to identify risk factors that precede most of these cases. Numerous heart and vascular illnesses can overlap with coarctation of the aorta. These conditions may increase the risk of developing aortic coarctation. Conditions that may indicate a higher risk for coarctation of the aorta include the following:
- Atrial septal defect
- Bicuspid aortic valve
- Congenital mitral valve stenosis
- Patent ductus arteriosus
- Subaortic stenosis
- Ventricular septal defect
How is aortic coarctation diagnosed?
The first step in diagnosing aortic coarctation is often comparing the lower and upper body pulse. If the aorta is narrowed, blood pulse further away from the heart may be comparatively weaker. After this, the physician may order further diagnostic tests if there are signs of coarctation of the aorta.
Tests that are often used to confirm aortic coarctation include the following:
- Echocardiogram
- Electrocardiogram (ECG)
- Magnetic resonance imaging (MRI)
- X-ray
How is aortic coarctation treated?
Coarctation of the aorta treatments focus on expanding the narrowed aorta and managing symptoms afterward. A few different procedures may be used for aortic coarctation repair.
Balloon angioplasty inserts a small, balloon-like object into the aorta via a catheter. The balloon expands the aorta, and a stent can be inserted to prevent the aorta from narrowing again. Recovery from this procedure can take from two to eight weeks.
Other nonsurgical treatments for aortic coarctation include blood pressure medications to manage high blood pressure.
Two of the most common surgical options to repair aortic coarctation are end-to-end anastomosis and bypass surgery.
Anastomosis removes the narrowed portion of the aorta and then connects the remaining sections of healthy aorta.
Bypass surgery attaches a graft onto the artery to create another route for the blood to flow. This method effectively bypasses the narrowed portion of the aorta.
Recovery from these surgeries can take two or three months.
How to prevent aortic coarctation
Coarctation of aorta causes are unknown, but this condition is most commonly a heart defect present at birth. Catching the disease early can improve your prognosis.
If you have other heart or vascular disorders, speak with your doctor about whether those conditions increase your risk of developing aortic coarctation. In some cases, avoiding high cholesterol may lower your chances of developing this condition later in life. High cholesterol can lead to atherosclerosis which can, in rare cases, cause adult-onset aortic coarctation.
How to live with aortic coarctation
Many people may have this condition without ever experiencing symptoms. In more severe cases, treatment is required. Even after treatment, ongoing medication may be needed to manage blood pressure and other lingering symptoms.
If you have a coarctation of aorta diagnosis or have been treated for this condition, it's crucial that you maintain regular appointments with your heart specialist.
FAQs
Aortic coarctation can often be effectively treated with surgery or balloon angioplasty. Still, people may need ongoing treatment to prevent recurrence and manage symptoms.
Severe cases can lead to life-threatening complications if left untreated. Risks like heart failure and brain aneurysms can arise. With treatment, however, the prognosis is often favorable.
The heart specialists at Mass General Brigham can diagnose and compose a treatment plan for aortic coarctation and other heart conditions that is best suited for your individual needs.
