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Aortic coarctation

Last reviewed: 10 Jan 2025
Last updated: 10 Dec 2024

Summary

Definition

History and exam

Key diagnostic factors

  • hypertension presenting at a young age or resistant to treatment
  • diminished lower extremity pulses
  • differential upper and lower extremity blood pressure (BP)
Full details

Other diagnostic factors

  • systolic ejection murmur
  • male sex
  • genetic syndrome
  • claudication
  • headache
  • systolic ejection click
  • other cardiac anomalies
Full details

Risk factors

  • male sex
  • young age
  • family history
  • Turner's syndrome
  • DiGeorge's syndrome
  • hypoplastic left heart syndrome
  • Shone's complex
  • PHACE syndrome
Full details

Diagnostic investigations

1st investigations to order

  • electrocardiogram (ECG)
  • chest x-ray (CXR)
  • echocardiogram
Full details

Investigations to consider

  • computed tomography (CT) angiography
  • magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA)
  • cardiac catheterisation
Full details

Treatment algorithm

ACUTE

critical coarctation

ONGOING

non-critical coarctationt

recurrent coarctation

Contributors

Authors

Jeffrey Gossett, MD
Jeffrey Gossett

Vice President and System Chief of Pediatric Cardiology

Professor of Pediatrics

Division of Pediatric Cardiology

Cohen Children’s Medical Center, Northwell Health

New Hyde Park

NY

Disclosures

JG declares that he has no competing interests.

Acknowledgements

Dr Jeffrey Gossett wishes to gratefully acknowledge Dr Anna Kamp, a previous contributor to this topic. AK declares that she has no competing interests.

Disclosures

AK declares that she has no competing interests.

Peer reviewers

Sheba John, MD, FAAP

Associate Professor

Pediatric Cardiology/Adult Congenital Cardiology

University of Utah

Salt Lake City

UT

Disclosures

SJ declares that she has no competing interests.

Daniel A. Cox, DO, FACC, FAAP, FAHA

Associate Professor

Adult Congenital and Pediatric Cardiology

University of Utah/Primary Children's Hospital

Salt Lake City

UT

Disclosures

DAC declares that he has no competing interests.

Sachin Khambadkone, MD, DCH, DNB

Consultant Paediatric Cardiologist and Honorary Senior Lecturer

Great Ormond Street Hospital and Institute of Child Health

London

UK

Disclosures

SK declares that he has no competing interests.

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  • Guidelines

    • ACR appropriateness criteria: congenital or acquired heart disease
    • Guidelines for cardiovascular intervention in adults with congenital heart disease
    More Guidelines
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