What are the Risk Factors for Coarctation of the Aorta (COA) or Aortic Narrowing?
Coarctation of the aorta or aortic narrowing happens along with other heart defects that are congenital, though the fact stays that even doctors are not aware of the reasons causing multiple heart defects. You or your child may have coarctation of the aorta or aortic narrowing in case these are some of the including heart conditions:
- Bicuspid Aortic Valve or BAV: The aortic valve of the heart divides the left ventricle (lower left chamber) from the aorta. A bicuspid aortic valve has two leaflets in the place of the usual three. Most people diagnosed with coarctation of the aorta or aortic narrowing are having a bicuspid aortic valve.
- Patent Ductus Arteriosus: Prior to birth, the blood vessel, ductus arteriosus is connecting the left pulmonary artery to the aorta, such that it permits the blood to bypass the lungs. Shortly after birth, the ductus arteriosus closes. In case it stays open, it is referred to as a patent ductus arteriosus.
- Holes between the left and right sides of the heart walls: There may be a hole in the wall between the upper chambers of the heart known as ASD (atrial septal defect) or on the lower chambers of the heart VSD or ventricular septal defect immediately after birth. This causes oxygen rich blood to mix with oxygen poor blood from the left to the right side of the heart.
- Aortic Valve Stenosis: AVS or aortic valve stenosis is a valve narrowing that separates the left ventricle from the aorta (aortic valve). This indicates your heart finds pumping harder to receive adequate blood flow to reach your body. However, over time, this may thicken your heart muscle and lead to heart failure.
- Aortic Valve Regurgitation: AVR or aortic valve regurgitation happens if the aortic valve is unable to close tightly, thereby causing the blood to leak backward reaching the left ventricle.
- Mitral Valve Stenosis: MVS or Mitral valve stenosis is a valve narrowing (mitral valve) between the left atrium (upper left heart chamber) and the left ventricle. In this condition it lets blood flow to the left side of your heart. However, in such condition, blood may get stocked into your lungs, resulting in breath shortness or lung congestion. Such a condition leads to heart failure.
- Mitral Valve Regurgitation: MVR or mitral valve regurgitation happens if the mitral valve fails to close tightly, thus causing the blood to leak into the left atrium.
- Nearly 10 percent girls and women with turner syndrome tend to have coarctation of the aorta or aortic narrowing.
Complications Involved in Coarctation of the Aorta (COA) or Aortic Narrowing
Coarctation of the aorta or aortic narrowing when left untreated leads to complications. Several complications may be due to high blood pressure long-standing that is caused by the coarctation of the aorta. Complications may be expected after the coarctation of the aorta or aortic narrowing treatment as well.
Coarctation of the aorta or aortic narrowing complications may include:
- High blood pressure
- Heart failure
- Enlargement in the aorta wall
- Rupture of aorta or tear of aorta/ dissection of aorta
- Bulging artery or a weakened artery or bleeding in the brain
- Coronary artery disease as premature causing narrowing of blood vessels.
If the coarctation of the aorta is severe, adequate blood may be difficult to pump by the heart. This results in damaging the heart and also in kidney or any other organ failure.
In case you are treated of coarctation of the aorta as you are young, there is a risk of aorta re-narrowing over a period of time. You may need treatments and you also are at a greater risk of developing high blood pressure.
How is Coarctation of the Aorta (COA) or Aortic Narrowing Diagnosed?
Coarctation of the aorta or aortic narrowing diagnosed at which age determines the severity of the condition. In case the coarctation of the aorta or aortic narrowing is severe, it is ideal to be diagnosed during infancy. Diagnosing Coarctation of the aorta or aortic narrowing before birth is just impossible.
Older children and Adults diagnosed with coarctation of the aorta or aortic narrowing have milder cases and may not show any signs and symptoms. They appear healthy until doctor detects:
- Delayed or weak pulse in the legs
- High blood pressure in the arms
- Heart murmur, a sound caused due to turbulent flow of blood
- Difference in blood pressure between legs and arms
Diagnostic Tests for Coarctation of the Aorta or Aortic Narrowing
Tests done confirming a coarctation of the aorta or aortic narrowing diagnosis may include:
- Echocardiogram: An echocardiogram detects the coarctation of the aorta or aortic narrowing severity and location and reveals other heart defects, such as a bicuspid aortic valve. Often, doctors use echocardiograms and diagnose COA, besides determining the appropriate treatment options.
- ECG Test: In case of severe coarctation of the aorta or aortic narrowing, the ECG reveals that the walls of the lower chambers of the heart are inflamed known as ventricular hypertrophy.
- X-ray of the Chest: A chest X-ray shows an enlarged heart, aorta narrowing and an enlarged aorta section.
- MRI Test: An MRI reveals the severity and the location of coarctation of the aorta or aortic narrowing, thus determines if it affects other blood vessels or not, and detects if you have other heart defects. This test helps in determining your treatment options for the doctor.
- CT Scan: A CT scan is done using a series of X-rays so that it creates detailed cross-sectional images of your body.
- CT Angiogram: In CT angiogram, a dye is injected by your doctor into a blood vessel so that the blood flow is highlighted in your veins and arteries. CT angiogram permits your doctor to see the coarctation of the aorta or aortic narrowing severity and location, thus determining if it affects the remaining blood vessels and also helps in detecting other heart defects, if any. Doctors use this scan report to determine the exact treatment options.
Cardiac Catheterization Test for Coarctation of the Aorta or Aortic Narrowing
In this procedure, doctor inserts a thin long tube (catheter) into your vein or artery in your groin and threads it using x-ray imaging to your heart.
Your doctor injects a dye to make your heart structures visible on X-ray pictures through the catheter. Cardiac catheterization helps in determining the coarctation of the aorta or aortic narrowing severity. It also measures oxygen and pressure levels in the heart chambers and in the blood vessels.
This test is not regularly used to diagnose coarctation of the aorta or aortic narrowing, but is done to assist doctors in planning surgery. The procedures of catheter may be done to perform the coarctation of the aorta certain treatments.