Coarctation of the aorta (Coarctatio aortae)

Coarctation of the aorta (narrowing of the aortic isthmus) is a congenital heart defect, which is characterized by narrowing of the lumen of the aorta, usually at the site of attachment of the ligamentum arteriosum, which is enough to lead to systolic pressure gradient in front of and behind the constriction.

Types of diseases

The narrowing can be localized in any part of the thoracic or abdominal aorta,

Symptoms and diagnosis

Usually has no symptoms.

In older people headaches, dizziness, epistaxis, pain in the legs of type claudicatio intermittens.

Clinical signs of

A well-developed, athletic person. Systolic thrill in the pit supraclavicular, visible  intercostal artery intercostal artery pulsations, noise sistolic ejection ype II in k space left, lI accented tone of aorta, interscapular systolic murmur.

Increased blood pressure in the upper limbs, down to the bottom.

Carotid artery pulsation, and art. radialis stronger than the femoral artery, which was reduced and lags.

Rtg

Left ventricular hypertrophy. In the esophagus there are impressions that give the appearance of the letter E. On the lower edge of the ribs (Roeslerov sign).

ECG

In milder cases may be normal, usually shows left ventricular hypertrophy.

Cardiac catheterization

It is not necessary, does not provide diagnostic information.

Angiocardiography

Is needed in most cases to assess the localization of stenosis. Retrograde aortography showed narrowing of the aortic position and size of poststenotic dilatation.

Functional characteristics of

Place a narrowing obstructing blood flow to the lower part of the body. Therefore, pressure increases in the area before opstruction to the development of collateral arterial network in order to maintain blood flow in the part below the obstruction.

Maintenance of high blood pressure conditions before the obstruction burdens pressing the left ventricle leads to its failure.

Maintenance of high pressure in blood vessels before the obstruction, especially cerebral, it may lead to their rupture.

Forecast

Prognosis of these patients, if treated surgically at the time was favorable. In surgical patients untreathed prognosis is bad. Death is usually the fourth or fifth decade of life due to heart failure or cerebral apoplexy.


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