Coarctation of the aorta is a constriction (narrowing) of
a part of the aorta, the main artery carrying "red blood" to the
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 .
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.
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.
The inferior aspects of posterior ribs 3 to 12 bilaterally are