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Interesting features of Coarctation of Aorta

Clinical presentation of coarctation
Most patients are asymptomatic
Symptomatic patients usually present with :
  • Headache
  • Dizziness
  • Epistaxis
  • Cold extremities
  • Weakness in the legs
  • Claudication with exercise
Clinical signs in coarctation
  • Hypertension in upper extremities with marked derease of pulsation in lower extremities.
  • Mid systolic or continuous murmur over anterior part of chest and back
  • Enlarged and pulsatile collateral vessels in intercostal spaces anteriorly in axilla or posteriorly in interscapular area
  • Upper extremity and thorax may be more developed in these patients than lower extremities.

ECG: shows  left ventricular hypertrophy
Indentation of aorta at site of coarctation and '3 sign' on paramediastinal shaddon are almost pathogenic of coarctation
Notching (erosion) of inferior surfaces of ribs.
Complications of coartation
  • Cerebral aneurysms and haemorrhage
  • Rupture of aorta
  • Left ventricular failure
  • Infective endocarditis
Treatment of coactation
In surgical resection of 'coarctation' and end to end anastomosis
Remember that Hypertension may not he corrected even after surgical correction of the 'coarctation'.
Interesting facts about coarctation
  • Most common site of coarctation of aorta is distal to origin of left subclavian artery.
  • Most common associated cardiac anomaly is bicuspid aortic valve.
  • It may be associated with  Turner's syndrome.