Learn more about the causes and treatment of this usually congenital heart condition that is treatable but requires lifelong follow-up.
The aorta is the largest artery in the body. It moves oxygen-rich blood from the heart to the rest of the body. Aortic coarctation (ko-ahrk-TAY-shun) is a narrowing of the aorta. It forces the heart to pump harder to move blood through the aorta.
Coarctation of the aorta is generally present at birth (congenital heart defect). Symptoms can range from mild to severe. The condition might not be detected until adulthood.
Coarctation of the aorta often occurs along with other congenital heart defects. Treatment is usually successful, but the condition requires careful lifelong follow-up.
Coarctation of the aorta is a narrowing (constriction) in a part of the body's main artery (aorta). The heart must pump more forcefully to send blood through the aorta and on to the rest of the body.
Coarctation of the aorta symptoms depend on how much of the aorta is narrowed. Most people don't have symptoms. Mild coarctation may not be diagnosed until adulthood.
Babies with severe coarctation of the aorta may show symptoms shortly after birth. Symptoms of coarctation of the aorta in infants include:
Symptoms of coarctation of the aorta after infancy commonly include:
Depending on where the coarctation is located, blood pressure may be high in the arms and low in the legs and ankles.
Coarctation of the aorta often occurs with other heart defects. Other symptoms depend on the type of congenital heart defect.
Seek medical help if you or your child has the following symptoms:
A complete health checkup helps determine the cause. If you or your child has sudden, unexplained chest pain, seek emergency medical care.
The cause of coarctation of the aorta is unclear. The condition is generally a heart problem present at birth (congenital heart defect).
Rarely, coarctation of the aorta develops later in life. Conditions or events that can narrow the aorta and cause this condition include:
Coarctation of the aorta can affect any part of the aorta, but it's most often located near a blood vessel called the ductus arteriosus. That blood vessel connects the left pulmonary artery to the aorta.
With coarctation of the aorta, the left lower heart chamber (left ventricle) works harder to pump blood through the narrowed aorta. As a result, blood pressure rises in the left ventricle. The wall of the left ventricle may become thick (hypertrophy).
Coarctation of the aorta is more common in males than in females. Having certain genetic conditions, such as Turner syndrome, also raises the risk of coarctation of the aorta.
Coarctation of the aorta often occurs along with other congenital heart defects. Heart conditions associated with coarctation include:
Prompt treatment is needed to help prevent complications. Without treatment, coarctation of the aorta in babies may lead to heart failure or death.
Long-term (chronic) high blood pressure is the most common complication of coarctation of the aorta. Blood pressure usually drops after repair surgery. But it may still be higher than usual.
Other complications of coarctation of the aorta may include:
If the coarctation of the aorta is severe, the heart might not be able to pump enough blood to the other organs. This can cause heart damage. It may lead to kidney failure or other organ failure.
Complications are also possible after treatment for coarctation of the aorta. These include:
People with coarctation of the aorta need regular health checkups for life.
There's no known way to prevent coarctation of the aorta. Early detection can help prevent complications. Talk to your health care provider if you or your child has a condition that increases the risk of aortic coarctation, such as Turner syndrome, bicuspid aortic valve or another heart defect. Also tell your provider if you have a family history of congenital heart disease.
The age at which coarctation of the aorta is diagnosed depends on the severity of the condition. Severe aortic coarctation is usually diagnosed soon after birth. The condition may be seen with ultrasound during pregnancy.
Adults and older children with mild coarctation of the aorta may not have symptoms and may appear healthy. A health care provider checks for the following when making a diagnosis of coarctation of the aorta:
Tests to confirm a diagnosis of coarctation of the aorta may include:
Cardiac catheterization. This test helps reveal blockages in the heart arteries. A long, thin flexible tube (catheter) is inserted in a blood vessel, usually in the groin or wrist, and guided to the heart. Dye flows through the catheter to arteries in the heart. The dye helps the arteries show up more clearly on X-ray images and video.
Cardiac catheterization can help determine the severity of the aortic coarctation. Catheter procedures may also be used to perform certain treatments for coarctation of the aorta.
Treatment for coarctation of the aorta depends on the age at the time of diagnosis and the severity of the condition. If there are other congenital heart defects, they may be repaired at the same time.
Treatment may include medications to control symptoms and procedures or surgery to repair the aorta.
Doctors trained in heart and blood vessel conditions (cardiologists), heart surgery (cardiovascular surgeons), and care providers trained in congenital heart disease help determine the most appropriate treatment for coarctation of the aorta.
Medication may be prescribed to control blood pressure before and, sometimes, after repair surgery. Although repairing aortic coarctation improves blood pressure, many people still need to take blood pressure drugs after a successful surgery or procedure.
Babies with severe coarctation of the aorta often are given a medication that keeps the ductus arteriosus open. This allows blood to flow around the narrowed area of the aorta until surgery is done.
There are several procedures and surgeries to repair aortic coarctation. Together, you and your health care team can discuss which type is most likely to be successful. Options include:
Balloon angioplasty and stenting. This may be the first treatment for aortic coarctation. Sometimes it's done if narrowing occurs again after coarctation surgery.
During balloon angioplasty, the doctor inserts a thin, flexible tube (catheter) into an artery in the groin. It's moved through the blood vessels to the heart using X-rays as a guide. An uninflated balloon is placed into the catheter and moved into the area of the narrowed aorta. The balloon is inflated. The inflated balloon widens the aorta, so blood flows more easily. Angioplasty is often combined with the placement of a small wire mesh tube called a stent. The stent helps keep the artery open, decreasing the chance of narrowing again.
After aortic repair surgery, health checkups are needed for life to measure blood pressure and monitor for complications.
Follow these tips to help manage the condition and prevent future heart problems:
If you or your child develops symptoms of coarctation of the aorta, call your health care provider. After the first exam, you or your child may be referred to a doctor trained in the diagnosis and treatment of heart conditions (cardiologist).
Here's some information to help you prepare for your appointment, and what to expect from your provider.
Questions to ask the provider at the first appointment include:
Questions to ask if you're referred to a cardiologist include:
Don't hesitate to ask your provider any other questions.
The health care provider will examine you or your child and ask several questions.
If you have coarctation of the aorta, the provider may ask:
If your baby or child is affected, the provider may ask: