Lightning Learning: Coarctation of the Aorta
Coarctation of the Aorta is a narrowing of the major vessel from the heart that delivers oxygen-rich blood to the body. It is fairly rare, affecting approximately 1 in every 10,000 births.
It accounts for approx 8% of all congenital heart defects. More common in males than females.
There are 3 types:
It is not fully understood why this condition occurs. There are certain genetic conditions that increase likelihood such as Turners Syndrome. It is also common to have other heart defects such as bicuspid valve of the aorta. Often present in first month of life, but can present at any age up to 40.
Difficulty in Breathing
Absent femoral pulses
4-limb blood pressure discrepancies
Pre/post ductal O2 saturation discrepancies
Diagnosis is made through history and clinical examination
Often present as collapsed neonate
Rapid A-E assessment; treat problems as you find them
ALWAYS check femoral pulses
ECG will show signs of RVH and right axis deviation
Four-limb BP can be useful but lacks specificity
CXR will show signs of cardiomegaly/pulmonary oedema
Prostaglandin Infusion (if neonate). Diuretics to reduce cardiac preload
Volume replacement needed as there will be metabolic acidosis, but be cautious and reassess frequently
Consult with Cardiology