Coarctation of Aorta

  • Coarctation of the Aorta results in stenosis of the aorta and thus reduced blood pressure distal to the stenosis. Coarctation can occur anywhere along the aorta but typically occurs just distal to the branching off of the left subclavian artery. Coarctation is relatively rare sporadically but is often associated with Turner Syndrome.
Clinical Consequences
  • Coarctation of the Aorta results in the left ventricle encountering a higher than normal resistance to ejection, thus requiring greater left ventricular systolic pressures to maintain cardiac output. Consequently, the left ventricle encounters an increased afterload which is compensated for by concentric left ventricular hypertrophy. Because coarctation typically occurs distal to the subclavian arteries the peripheral pulses in the arms are often exaggerated and patients may appear hypertensive by manometer. However, because blood pressure is reduced following the coarctation, peripheral pulses in the legs or femoral arteries are often diminished and the lower extremities may appear somewhat cyanotic. Over time, extensive enlargement of the intercostal arteries can develop in an attempt to bypass the coarctation. These large collateral vessels can often be observed on the ribs.