Clinical manifestations and diagnosis of coarctation of the aorta
- Brojendra N Agarwala, MD
Brojendra N Agarwala, MD
- Professor of Pediatrics
- Pritzker School of Medicine of the University of Chicago
- Emile Bacha, MD, FACS
Emile Bacha, MD, FACS
- Calvin F. Barber Professor of Surgery
- Columbia University College of Physicians and Surgeons
- Qi Ling Cao, MD
Qi Ling Cao, MD
- Director, Echocardiography Research Laboratory, Cardiac Program
- Sidra Medical and Research Center
- Doha, Qatar
- Ziyad M Hijazi, MD, MPH, FAAP, FACC, MSCAI, FAHA
Ziyad M Hijazi, MD, MPH, FAAP, FACC, MSCAI, FAHA
- Professor of Pediatrics, Weill Cornell Medicine
- Chairman, Department of Pediatrics & Director, Cardiac Program
- Sidra Medical & Research Center
- Doha, Qatar
- Section Editors
- David R Fulton, MD
David R Fulton, MD
- Section Editor — Pediatric Cardiology
- Associate Professor of Pediatrics
- Harvard Medical School
- Heidi M Connolly, MD, FASE
Heidi M Connolly, MD, FASE
- Section Editor — Congenital Heart Disease
- Professor of Medicine
- Mayo Medical School
Coarctation of the aorta is a narrowing of the descfending aorta, which is typically located at the insertion of the ductus arteriosus just distal to the left subclavian artery (figure 1). This defect generally results in left ventricular pressure overload.
The clinical manifestations and diagnosis of coarctation of the aorta will be reviewed here. The management of coarctation, including corrective treatment options and outcome, such as the risk of recurrent coarctation, is discussed separately. (See "Management of coarctation of the aorta".)
Coarctation of the aorta accounts for 4 to 6 percent of all congenital heart defects with a reported prevalence of approximately 4 per 10,000 live births [1,2]. It occurs more commonly in males than in females (59 versus 41 percent) . Most cases are sporadic.
PATHOGENESIS AND ETIOLOGY
Although there are acquired causes, the etiology of coarctation of the aorta is generally congenital.
Congenital — The vast majority of coarctation cases are congenital. Although the precise pathogenesis is unknown, the two main theories for the development of congenital coarctation of the aorta are:
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- PATHOGENESIS AND ETIOLOGY
- - Genetic factors
- Anatomical variants
- Other cardiac lesions
- CLINICAL MANIFESTATIONS
- Manifestations according to age
- - Neonates
- - Older infants and children
- - Adults
- Natural history
- Physical findings
- - Blood pressure and pulses
- - Cardiac examination
- Noncardiac manifestations
- - Intracranial aneurysms
- - Turner syndrome
- ECG and X-ray findings
- - Electrocardiogram
- - Chest radiograph
- Prenatal diagnosis
- Postnatal diagnosis
- - Echocardiography
- - Magnetic resonance imaging/computed tomography
- - Cardiac catheterization
- DIFFERENTIAL DIAGNOSIS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS