Learning that your baby has coarctation (pronounced ko-ahrk-TAY-shun) of the aorta can be a scary time for any parent, and you likely have many questions about what this means for your baby and their future. Coarctation of the aorta is a congenital heart defect (CHD) in which part of the aorta — the largest artery in the body — is narrower than in most people. Coarctation of the aorta affects over 2,000 babies born in the U.S. annually.
Coarctation of the aorta is known as a critical congenital heart defect (critical CHD) because of the potential for serious health problems if it goes undiagnosed. Fortunately, advances in modern medicine mean that babies born with congenital heart defects generally live long, healthy, independent lives.
What Are Congenital Heart Defects?
Congenital heart defects are birth defects that affect the structure or function of a baby's heart. CHDs are the most common type of birth defect.
Babies are born with CHDs — congenital means "present at birth" — and these defects can be mild or severe. Some CHDs are so mild that a doctor doesn't diagnose them until adulthood.
Critical CHDs like coarctation of the aorta affect about 25% of all babies born with a CHD. Babies with a critical CHD typically need surgery or other medical procedures in their first year of life, and some babies will need multiple surgeries over several years.
How Does Coarctation of the Aorta Affect the Body?
A narrow aorta forces your baby's heart to pump harder to move blood through their body. The narrow part of the aorta is typically located in the upper body. It can lead to high blood pressure in the head and upper body and low blood pressure in the legs and lower body.
Coarctation of the aorta can be mild to severe. A doctor might not diagnose the condition in mild cases until adulthood. In severe cases, the heart may not pump enough blood to the lower part of the body, and the extra strain on the heart can weaken it over time and lead to heart failure.
Coarctation of the aorta often occurs with other CHDs.
What Causes Coarctation of the Aorta?
Coarctation of the aorta is typically a heart defect present at birth. Rarely, this condition can develop later in life from injury or diseases such as atherosclerosis or Takayasu arteritis.
Coarctation of the aorta causes, like the causes for most CHDs, aren't currently known. It's thought that CHDs may be caused by both genetic and environmental factors.
Risk factors for coarctation of the aorta and other congenital heart defects include:
- Contracting rubella (German measles) during pregnancy
- Diabetes (gestational diabetes does not typically increase the risk of heart defects)
- Medications, like some statins, anti-anxiety drugs, anticonvulsants, and acne medications
- Drinking alcohol during pregnancy
- Smoking during pregnancy
- Genetics
How Is Coarctation of the Aorta Diagnosed?
A doctor typically diagnoses coarctation of the aorta after a baby is born, and more severe cases have more obvious signs.
Coarctation of the aorta symptoms in infants include:
- Pale skin
- Irritability
- Heavy sweating
- Difficulty breathing
- Difficulty feeding
Symptoms of coarctation of the aorta after infancy include:
- Chest pain
- Headaches
- High blood pressure
- Leg cramps
- Muscle weakness
- Nosebleeds
A doctor often detects coarctation of the aorta during routine well-baby visits. The pulse is weaker in the lower body than in the upper body, and your doctor may hear a heart murmur — swishing or whooshing sounds made by abnormal blood flow— with a stethoscope.
If your doctor suspects coarctation of the aorta, an echocardiogram will likely be used to make a diagnosis. An echocardiogram is an imaging test that uses ultrasound to allow your doctor to see the heart pumping blood. An echocardiogram is a safe and painless procedure.
How Is Coarctation of the Aorta Treated?
In coarctation of the aorta treatment, the aorta is widened surgically or through a balloon angioplasty procedure. During a balloon angioplasty, a catheter — a flexible tube — is guided through a blood vessel to the aorta. When it reaches the narrow area, it's inflated to widen the aorta.
The surgeon may place a stent — a tube designed to keep the aorta open. Most stents are made out of expandable metal mesh and are permanent. A person with a stent might be prescribed an antiplatelet medicine to prevent blood clots from forming inside the stent.
After surgery to widen the aorta, high blood pressure remains a problem for many children. Your doctor may treat your child's blood pressure with medication.
People of any age with coarctation of the aorta need to be monitored by a cardiologist — doctors specializing in the heart and cardiovascular system — for the rest of their life.
What Is the Prognosis for Coarctation of the Aorta?
Life expectancy for coarctation of the aorta has historically been poor, with a mean lifespan of 35 years. However, advances in cardiology have drastically improved outcomes for patients with coarctation of the aorta.
While this is still a serious condition requiring lifelong medical care, these individuals now have very good survival rates. They can expect to live a normal life after treatment.