Coarctation of the Aorta

Overview

Coarctation of the aorta is a congenital narrowing of the body’s main artery. This artery, the aorta, carries blood from the heart to the body. With less room for blood to pass through the aorta, the heart has to work harder to send blood to the body, which can weaken the muscle over time and lead to dysfunction. Most people born with coarctation of the aorta are diagnosed and undergo surgical repair as babies, but repair is possible for adults. All adults with coarctation of the aorta should see a cardiologist with expertise in congenital heart defects for ongoing care.

Symptoms

Coarctation of the aorta often doesn’t cause symptoms in adults, but some individuals may experience:

Fatigue when walking or running
Headaches
High blood pressure
Kidney problems
Miscarriages

Prevention

Coarctation of the aorta is a condition that is present at birth and cannot be prevented.

Risk Factors

Boys are more likely to be born with coarctation of the aorta than girls. Other risk factors include certain genetic disorders, such as Turner syndrome, certain maternal behaviors during pregnancy and maternal exposure to environmental hazards during pregnancy.

Diagnosis

Medical history. Your cardiologist will ask about your health history, any medications you take and any symptoms you’ve experienced recently.
Physical exam. The cardiologist will take your blood pressure in your arms and legs. Higher pressure in the former may be a sign of coarctation of the aorta. The cardiologist will also check the pulse in your legs and use a stethoscope to listen for a heart murmur, another potential sign of a narrow aorta.
Echocardiogram. With this ultrasound of the heart, your cardiologist may be able to see any narrowing of the aorta.
X-ray, CT and MRI. Your cardiologist may order one or more of these imaging tests to help pinpoint the location and extent of aortic narrowing.
Electrocardiogram. This test of the heart’s electrical activity may show dysfunction related to coarctation of the aorta.
Cardiac catheterization. This procedure involves sending a catheter to your heart through a vein or artery and injecting dye so a cardiologist can see your heart and blood vessels with X-ray. Cardiac catheterization can help the physician determine how much the aorta is narrowed.

Treatment

Most adults newly diagnosed with coarctation of the aorta are candidates for repair using cardiac catheterization, which is less invasive than open surgery. During the procedure, a cardiologist sends a balloon-tipped catheter through a blood vessel to your aorta and inflates the balloon to widen the artery. To ensure the aorta stays open, the cardiologist may also place a mesh tube called a stent. If you had a cardiac catheterization or surgery to repair coarctation of the aorta as a child, you may need to undergo cardiac catheterization as an adult if more narrowing of the aorta occurs.
If you undergo surgery, the surgeon will remove the diminished portion of your aorta and reconstruct it or replace it with a patch.

Follow-up Care

Whether you were diagnosed and underwent treatment as a child or an adult, you’ll need to see a cardiologist who specializes in adult congenital heart disease, such as those found at the Kentucky Adult Congenital Heart Program, at least once each year.

Your cardiologist will use imaging to monitor your aorta for additional narrowing and determine whether you need another procedure to widen the artery. He or she can also diagnose and treat heart problems related to coarctation of the aorta, including high blood pressure, coronary artery disease and aortic aneurysm.
It’s important to clear physical activities with your cardiologist, as he or she may advise against certain strength-training exercises.