Coarctation of the Aorta

Overview

Coarctation is a narrowing of the aorta that creates an obstruction to systemic blood flow.

Clinical Features

Severe neonatal disease may present with heart failure, poor perfusion, acidosis, and shock.

Older patients may have hypertension in the upper limbs and weak or delayed femoral pulses.

Always compare upper- and lower-limb blood pressure or pulses when coarctation is suspected.

Investigation

Echocardiography is commonly used, with CT or MR angiography providing additional anatomical information in selected patients.

Management

Critically ill neonates may require prostaglandin therapy to maintain ductal flow while definitive treatment is arranged.

Definitive treatment may be surgical or catheter-based depending on age and anatomy.

Clinical Pearls