What is Coarctation of the Aorta (COA)?

Coarctation of the Aorta, or COA, is a common congenital heart defect where the aorta is narrowed. Coarctation originates from the Latin word coartare, which means “to press together.” A pinched or squeezed aorta restricts normal blood flow through the aorta. The condition is also sometimes diagnosed in adulthood.

Causes

There is no clear agreement among medical professionals on the causes of COA. The major reason for the uncertainty around Coarctation of Aorta causes is that the condition is generally present at birth, having developed during pregnancy. However, certain events can lead to the development of COA later in life.

Life events that can lead to COA:

• Amassing of fat, cholesterol, and other substances in and on the walls of your arteries (Atherosclerosis).
• Severe injury from trauma.
• Swollen and irritated arteries (Takayasu’s Arteritis).

Symptoms

Most individuals with COA don’t show symptoms. Therefore, COA may not be diagnosed until adulthood.

In severe cases, babies may have the following Coarctation of Aorta symptoms shortly after birth:

• Trouble feeding
• Irritability
• Increased sweating
• Pallid or pale skin
• Problems breathing

Coarctation of Aorta signs that occur later in life can include:

• Headaches
• Nosebleeds
• Weaker muscles
• Easily exhausted
• High blood pressure
• Chest pain
• Leg cramps
• Cold feet
• Chest discomfort or pain

Diagnosis

COA causes high blood pressure in the upper body and arms. The condition also leads to low blood pressure in the lower body and legs, which is how your doctor will typically diagnose the condition. Your doctor may also make a Coarctation of Aorta diagnosis by identifying a distinctive heart murmur during a medical exam. Your doctor will generally order additional tests to confirm the diagnosis.

These confirming tests include:

• Electrocardiogram, or ECG: This test measures the electrical activity of your heart.
• Chest X-ray: Captures images of your chest and lungs.
• Echocardiography: This noninvasive test measures your heart’s movements.
• Chest computed tomography (CT scan or CAT scan): A CT scan uses a batch of X-rays to produce comprehensive cross-sectional images of your body.
• Magnetic Resonance Imaging, or MRI: An MRI uses both a magnetic field and controlled radio waves to generate clear images of your heart and blood vessels.
• Cardiac catheterization: A catheter, or long thin tube, is inserted into your vein or artery to reach your heart.

Treatment

Treatment for COA depends on your age at the time of diagnosis, your general health, and the severity of the condition. Surgery or other medical procedures are the main source of treatment. Your doctor may also prescribe medication to manage your blood pressure before and after the procedures.

Your doctor may perform the following procedures to treat, correct or repair COA:

• Bypass graft repair: Your doctor will insert a tube called a graft between parts of your aorta to bypass the pinched or narrowed area.
• End-to-end anastomosis: Your doctor will remove the pinched section of the aorta and then connect the two healthy parts of the aorta.
• Patch aortoplasty: Your doctor will make an incision across the area of the aorta that is narrowed. Next, your doctor will connect a patch of synthetic material to expand or widen the blood vessel.
• Subclavian flap aortoplasty: Your doctor might use a part of the blood vessel that sends blood to your left arm to enlarge the narrowed aorta.
• Balloon angioplasty and stenting: Your doctor uses a catheter and medical balloon to widen the aorta.

If you or a loved one experience any symptoms of COA, please contact your Baptist physician.