What are the symptoms of coarctation of the aorta?
The degree of narrowing in coarctation of the aorta can be different in different people. Some babies will be born with severe narrowing which can lead to symptoms soon after they are born (see below). However, in others, the narrowing is less severe and symptoms may not be noticed until later. In some people, the narrowing may gradually get worse over time and therefore lead to symptoms. Occasionally, coarctation of the aorta does not cause any symptoms or is not detected until adult life.
Symptoms result from heart failure because the heart is not able to push blood through the narrowed part of the aorta. This causes a back-pressure of blood and congestion of the lungs, leading to symptoms including shortness of breath.
Patients with less severe narrowing will present later as they develop extra blood vessels, called collateral blood vessels, so that some blood is able to bypass the narrowed part of the aorta. These collateral blood vessels may be enough for some time but, eventually, the heart is no longer able to cope and symptoms of heart failure start to appear.
Are there signs that may be spotted before symptoms develop?
The following may be picked up:
- During a routine check in a baby or child, the healthcare professional may hear a heart murmur when they listen to the child's heart. A heart murmur is an extra sound amongst the heartbeats that the healthcare professional may hear.
- Presence of high blood pressure and blood pressure in the arms being much higher than in the legs.
- Difference in the timing of the pulses between the arms or the arm and legs. The pulses in the legs may be weaker.
What are the symptoms of severe narrowing?
Symptoms may present early, ie in the first few weeks of life (as the ductus arteriosus closes):
- There may be poor feeding.
- There may be heart failure signs: breathlessness; a rapid breathing rate; swelling of the body.
Symptoms may not become obvious until later in childhood (and sometimes even adulthood).
Eventually the heart is no longer able to cope and heart failure develops, with shortness of breath, coughing, feeling tired and swelling of the feet and legs.
Further reading and references
Balloon angioplasty or stenting for coarctation or recoarctation of aorta; NICE Interventional Procedure Guidance, July 2004
Vijayalakshmi K, Griffiths A, Hasan A, et al; Late hazards after repair of coarctation of the aorta. BMJ. 2008 Apr 5336(7647):772-3.
Ijland MM, Tanke RB; Aortic coarctation. Circulation. 2009 Sep 29120(13):1294-5.
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