Patient education: Aortic coarctation in adults (The Basics)

What is aortic coarctation? — 

This is a heart defect that causes the heart's largest vessel, called the "aorta," to narrow (figure 1). People with aortic coarctation are born with it. But they might not find out they have it until they are adults. People with aortic coarctation often also have a heart valve problem.

What are the symptoms of aortic coarctation? — 

People with aortic coarctation usually have high blood pressure in their arms (especially the right arm), but low blood pressure in their legs. Also, their pulse is much weaker in their groin area than in their neck or arms.

Most people do not have any other symptoms. But some do have 1 or more of the following symptoms:

●Headache

●Nosebleeds

●Trouble breathing, especially when exercising

●Fatigue

●Leg cramps

●Chest pain – People can develop a couple of different types of chest pain:

•"Angina" – This is chest pain, pressure, or discomfort that happens when the heart muscle does not get enough blood to supply its needs.

•"Aortic dissection," also called "aortic rupture" – This is a severe, sharp, "tearing" pain in the chest or back that is caused by a tear in the aorta.

●Sudden facial droop or uneven face, weakness or numbness in an arm, or trouble speaking – These are symptoms of a stroke. This is when a part of the brain is damaged because of a problem with blood flow. Strokes can happen if an artery in the brain closes off or starts to bleed.

Are there tests for aortic coarctation? — 

Yes. The doctor will do an exam and measure your pulse and blood pressure in your arms and legs. Other tests include:

●Electrocardiogram ("ECG") – This measures the electrical activity of the heart.

●Chest X-ray – This can show if there is fluid in the lungs. This can happen if the heart is not working as well as it should. The X-ray also lets the doctor see the general shape of the heart and the large blood vessels in the chest. In some people with aortic coarctation, the chest X-ray shows some changes in the ribs.

●Echocardiogram ("echo") – This uses sound waves to take pictures of the heart and aorta.

●MRI or CT scan – These take pictures of the aorta, as well as the blood vessels in the head.

●Cardiac catheterization ("cardiac cath") – The doctor puts a thin tube into a blood vessel in the leg or arm. Then, they move the tube up to the heart. Next, the doctor puts a dye that shows up on X-rays into the tube. This part of the test is called "angiography." It can show how much the aorta has narrowed. The doctor might also use dye to look at the blood supply to the heart.

How is aortic coarctation treated? — 

High blood pressure is common in people with aortic coarctation. There are medicines to treat this.

Some people with aortic coarctation need a procedure to fix their aorta. The type of procedure depends how much your aorta has narrowed, your symptoms, and your age. Procedures include:

●Angioplasty – A doctor puts a thin tube into a blood vessel in your leg or arm and moves the tube to your aorta. Then, they inflate a balloon inside the narrow part of your aorta to widen it. In some cases, the doctor props open your aorta using a mesh tube called a "stent."

●Surgery – Different types of surgery can fix the narrowed aorta. The surgeon might remove the narrowed part of your aorta. In some cases, they use a plastic tube called a "graft" or a piece of another one of your blood vessels to fix your aorta.

What if I want to get pregnant? — 

Talk to your doctor about the risks before you start trying. Some people with aortic coarctation might need a procedure to fix their aorta before they get pregnant. Most people who had their coarctation successfully fixed can safely have a baby.

For some people who have not been treated for aortic coarctation, pregnancy can be dangerous. The most common problem is high blood pressure. Most people whose blood pressure is normal during pregnancy can have the coarctation fixed after the baby is born. But if your blood pressure gets too high, you might need to take medicine to control it. In some cases, you might need a procedure to fix your aorta before you give birth.

What will my life be like? — 

Many people with aortic coarctation can live normal lives. But high blood pressure and aortic coarctation can return after treatment. You need to see your doctor regularly and get follow-up testing. Also, check with your doctor about what types of exercise you can do.

More on this topic

Patient education: Aortic coarctation in children (The Basics)
Patient education: High blood pressure in adults (The Basics)
Patient education: Angina (The Basics)
Patient education: Aortic dissection (The Basics)
Patient education: Stroke (The Basics)
Patient education: Stenting for the heart (The Basics)
Patient education: Coronary artery disease (The Basics)

Patient education: High blood pressure in adults (Beyond the Basics)
Patient education: Stroke symptoms and diagnosis (Beyond the Basics)
Patient education: Stenting for the heart (Beyond the Basics)