Aortic coarctation

Descripción general 
Teoría 
Diagnóstico 
Manejo 
Seguimiento 
Recursos 

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ბოლო მიმოხილვა: 18 Feb 2026

ბოლო განახლება: 10 Dec 2024

Aortic coarctation is characterized by a blood pressure differential between upper and lower extremities (upper >lower).

In neonates, may present with shock if there is inadequate systemic perfusion once the ductus arteriosus closes.

Physical exam may show diminished, absent, or delayed lower extremity pulses compared with upper extremity pulses.

Diagnosis is made by demonstration of aortic arch narrowing, typically by echocardiography.

Treatment may be surgical repair or percutaneous balloon dilation or stent placement.

Long-term complications include persistent hypertension or aneurysm formation at site of surgery or balloon.

განსაზღვრება

Coarctation of the aorta is defined as a narrowing in the aorta, most commonly at the site of insertion of the ductus arteriosus, just distal to the left subclavian artery. Less commonly, there may be diffuse arch hypoplasia with a long segment of narrowing, proximal to the left subclavian artery, or the obstruction may be in the abdominal aorta. It is often associated with a diffuse arteriopathy and bicuspid aortic valve. It typically presents with upper extremity systolic hypertension or murmur. If the narrowing is severe, it may present in the newborn period once the ductus arteriosus closes as low cardiac output and shock (critical coarctation).

ანამნეზი და გასინჯვა

ძირითადი დიაგნოსტიკური ფაქტორები

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

სრული ტექსტი

სხვა დიაგნოსტიკური ფაქტორები

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

სრული ტექსტი

რისკფაქტორები

male sex
young age
family history
Turner syndrome
DiGeorge syndrome
hypoplastic left heart syndrome
Shone complex
PHACE syndrome

სრული ტექსტი

დიაგნოსტიკური კვლევები

1-ად შესაკვეთი გამოკვლევები

electrocardiogram (ECG)
chest x-ray (CXR)
echocardiogram

სრული ტექსტი

გასათვალისწინებელი კვლევები

computed tomography (CT) angiography
magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA)
cardiac catheterization

სრული ტექსტი

მკურნალობის ალგორითმი

მწვავე

critical coarctation

მიმდინარე

noncritical coarctation

recurrent coarctation

კონტრიბუტორები

ავტორები

Jeffrey Gossett, MD

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

გაფრთხილება:

JG declares that he has no competing interests.

მადლიერება

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

გაფრთხილება:

AK declares that she has no competing interests.

რეცენზენტები

Sheba John, MD, FAAP

Associate Professor

Pediatric Cardiology/Adult Congenital Cardiology

University of Utah

Salt Lake City

გაფრთხილება:

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

Раскрытие информации

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

Раскрытие информации

SK declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Erbel R, Aboyans V, Boileau C, et al; Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. Eur Heart J. 2014 Nov 1;35(41):2873-926.Полный текст

Writing Committee Members, Isselbacher EM, Preventza O, et al. 2022 ACC/AHA Guideline for the diagnosis and management of aortic disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022 Dec 13;80(24):e223-e393.Полный текст Аннотация

Baumgartner H, De Backer J, Babu-Narayan SV, et al. 2020 ESC guidelines for the management of adult congenital heart disease. Eur Heart J. 2020 Aug 29;ehaa554.Полный текст

Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC Guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol. 2019 Apr 2;73(12):e81-192.Полный текст

Writing Committee; Riambau V, Böckler D, Brunkwall J, et al. Editor's choice - management of descending thoracic aorta diseases: clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2017 Jan;53(1):4-52.Полный текст

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Отличия
- Aortic stenosis (AS)
- Interrupted aortic arch
- Left ventricular outflow tract obstruction
Больше Отличия
Рекомендации
- ACR appropriateness criteria: congenital or acquired heart disease
- Guidelines for cardiovascular intervention in adults with congenital heart disease
Больше Рекомендации
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Использование этого контента попадает под действие нашего заявления об отказе от ответственности

Aortic coarctation

შეჯამება

განსაზღვრება

ანამნეზი და გასინჯვა

ძირითადი დიაგნოსტიკური ფაქტორები

სხვა დიაგნოსტიკური ფაქტორები

რისკფაქტორები

დიაგნოსტიკური კვლევები

1-ად შესაკვეთი გამოკვლევები

გასათვალისწინებელი კვლევები

მკურნალობის ალგორითმი

critical coarctation

noncritical coarctation

recurrent coarctation

კონტრიბუტორები

ავტორები

Jeffrey Gossett, MD

გაფრთხილება:

მადლიერება

გაფრთხილება:

რეცენზენტები

Sheba John, MD, FAAP

გაფრთხილება:

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

Раскрытие информации

Sachin Khambadkone, MD, DCH, DNB

Раскрытие информации

Peer reviewer acknowledgements

Disclosures

Список литературы

Основные статьи

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Отличия

Рекомендации

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Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

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