Coartation of Aorta

 


Definition
Coarctation of the aorta is a constriction (narrowing) of a part of the aorta, the main artery carrying "red blood" to the body.
 
Radiographic Appearance
Posteroanterior (PA) and lateral chest radiographs demonstrate mild dilatation of the ascending aorta with filling of the anterior clear space , localized narrowing of the distal aortic arch , and mild dilatation of the descending aorta. These prestenotic and poststenotic dilatations result in a "figure 3" appearance of the aorta. The left ventricle is hypertrophied and the pulmonary blood flow is normal. The inferior aspects of posterior ribs 3 to 12 bilaterally are notched .
 
Pathology
This generally occurs close to the region where arteries to the head and neck arise. The constriction obstructs blood flow to the lower parts of the body. It causes blood pressure to increase above the coarctation, resulting in higher blood pressure in the upper part of the body compared with the lower part of the body.

The left side of the heart works hard as it tries to pump blood past the coarctation. This may cause the left ventricle to enlarge. If the coarctation is very severe, an infant's heart may fail, resulting in rapid heart rate, rapid breathing and poor feeding. In less severe narrowing, the child may have no noticeable side effects except increased blood pressure. If the high blood pressure continues, damage results to other blood vessels in the body.
 
Treatment:
Surgery may be needed to correct the defect, depending on the severity of the coarctation and the presence of other congenital defects. Another option may be a balloon angioplasty.
 
Images


The inferior aspects of posterior ribs 3 to 12 bilaterally are notched

http://brighamrad.harvard.edu
 

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