Aortic coarctation

Last reviewed: 27 Aug 2022
Last updated: 29 Sep 2021

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)
More key diagnostic factors

Other diagnostic factors

  • systolic ejection murmur
  • male sex
  • genetic syndrome
  • claudication
  • headache
  • systolic ejection click
  • other cardiac anomalies
Other diagnostic factors

Risk factors

  • male sex
  • young age
  • family history
  • Turner's syndrome
  • DiGeorge's syndrome
  • hypoplastic left heart syndrome
  • Shone's complex
  • PHACE syndrome
More risk factors

Diagnostic investigations

1st investigations to order

  • electrocardiogram (ECG)
  • chest x-ray (CXR)
  • echocardiogram
More 1st investigations to order

Investigations to consider

  • computed tomography (CT) angiography
  • magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA)
  • cardiac catheterisation
More investigations to consider

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

Ranjit Aiyagari, MD

Clinical Assistant Professor of Pediatrics

University of Michigan

Ann Arbor

MI

Disclosures

RA 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.

  • Aortic coarctation images
  • Differentials

    • Aortic stenosis (AS)
    • Interrupted aortic arch
    • Left ventricular outflow tract obstruction
    More Differentials
  • Guidelines

    • 2020 ESC Guidelines for the management of adult congenital heart disease: The Task Force for the management of adult congenital heart disease of the European Society of Cardiology (ESC)
    • Management of descending thoracic aorta diseases
    More Guidelines
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