What is aortic coarctation?

Aortic coarctation is a heart condition that is also called 'coarctation of the aorta'.

It is a narrowing of a section of your aorta — your biggest blood vessel, or artery. Your aorta delivers blood from the left side of your heart to your body.

Your heart has to pump extra hard to move the blood through the narrowed section. It can cause:

• blood flow to increase in your head, arms and upper part of your body
• blood flow to decrease in your legs and lower part of your body

What are the symptoms of aortic coarctation?

The symptoms depend on how severe the narrowing is.

Babies with severe narrowing can become very unwell suddenly and need urgent treatment. This most commonly happens in the newborn period.

Babies with coarctation of the aorta may:

• have pale, bluish or mottled skin
• sweat heavily
• have trouble breathing
• breathe very rapidly
• feed poorly
• become irritable

Children with a mild narrowing of their aorta may not have obvious symptoms. They might be found to have high blood pressure.

Other symptoms and signs or aortic coarctation can include:

• a heart murmur
• leg pain or cramps when walking
• headaches
• chest pain
• nosebleeds
• cold feet

What causes aortic coarctation?

Aortic coarctation is usually a condition you are born with — a congenital heart condition.

Babies have a higher risk of aortic coarctation if they:

• have a family history of heart defects
• have other heart conditions
• have a certain genetic disorders, including Turner syndrome

Very occasionally, aortic coarctation can develop due to:

• Takayasu vasculitis, which is a type of inflammation of the aorta
• severe atherosclerosis — hardening of the arteries

When should I see my doctor?

Older children or adults should see their doctor if they have symptoms, including unexplained high blood pressure.

If you know your baby may be at increased risk, tell your doctor or midwife. Early detection can help.

How is aortic coarctation diagnosed?

Your doctor will ask about your (or your child's) symptoms and perform a physical examination.

The simplest way for a doctor to detect aortic coarctation is to look for a difference in pulse and blood pressure between the arms and legs. Aortic coarctation causes higher blood pressure in the arms than the legs.

Tests that can help confirm the diagnosis include:

• an electrocardiogram (ECG) — which measures your heart's electrical activity
• an echocardiogram — which uses ultrasound waves to produce images of the heart beating
• an MRI scan — which can show the details of your aorta and other blood vessels
• a chest x-ray

How is aortic coarctation treated?

The treatment for aortic coarctation usually involves an operation. There are different approaches, including:

• Balloon angioplasty — where the narrowed section is expanded by inserting a balloon into the aorta.
• Insertion of a stent — which is a small mesh tube that holds the aorta open.
• Surgery to replace or reshape the narrowed section of the aorta.

Some babies need this done urgently, while others can wait longer. Some children will also have other heart defects repaired at the same time.

In babies who are very unwell in the first few days of life, other emergency treatments might be given before surgery. These may include medicines, fluids or help with breathing.

Ongoing monitoring and treatment

If you have a repaired aortic coarctation, it's important to see your heart specialist regularly throughout life.

Your specialist will monitor your condition and check:

• for ongoing high blood pressure
• that your aorta has not become narrowed again
• that you have not developed an aneurysm (bulge in a blood vessel wall)

Complications of aortic coarctation

Possible complications of aortic coarctation can include:

• high blood pressure
• heart failure
• an aneurysm forming where the aorta was repaired or widened

People with congenital heart disease can have a higher risk of depression and anxiety.

Resources and support

HeartKids offers support to people affected by childhood heart disease — you can call the HeartKids Helpline on 1800 432 785.

For further information about heart disease, visit the Heart Foundation.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.