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Aortic coarctation is a congenital heart condition, meaning it’s present at birth. It occurs because a narrowing in the aorta restricts blood flow to the rest of the body. Although many people with aortic coarctation are diagnosed as infants, some people with mild coarctation may not be diagnosed until later in life when they start to have symptoms.
Coarctation of the aorta, also known as aortic coarctation, is most commonly a congenital heart condition. Congenital means that the condition is present at birth. In some cases, aortic coarctation develops later in life due to a traumatic injury or severe hardening of the arteries, known as atherosclerosis.
The aorta is the largest artery in the body and carries blood from the heart to the rest of the body. With aortic coarctation, the aorta is narrowed or constricted. This restricted blood flow forces the heart to work harder to pump blood throughout the body. It may lead to high blood pressure or heart failure.
In most cases, the cause is unknown. Genes play a role, as may environment, medications, lifestyle choices, or a combination of several factors.
It is common for children with aortic coarctation to also have other heart defects.
A combination of genetic and other factors may increase a person’s risk of having a baby with aortic coarctation. Some heart defects are due to mutations or changes in genes or chromosomes. Environmental factors, diet, medications, and other things also can play a role.
Another theory is that extra tissue from the ductus arteriosus blood vessel molds into the aortic tissue when it closes up after birth. The ductus arteriosus helps blood in the fetus bypass its lungs while in utero. When the baby is born, the tissue tightens to allow the blood vessel to close. The extra tissue may also tighten, narrowing the aorta.
Although the cause is not certain, some factors have been linked to heart defects in babies.
These risk factors include being pregnant and:
If aortic coarctation is severe, heart failure is a risk.
The narrowing in the aorta may prevent the lower body from getting enough blood. This makes the heart pump harder, which can cause the walls to thicken and eventually damage the heart muscle so much that it leads to heart failure.
Without treatment, most people die before age 40.
One of the more common congenital heart defects, aortic coarctation accounts for about 5% of all congenital heart defects. About 1 in every 1,712 U.S. babies is born with coarctation of the aorta, or about 2,416 nationwide each year.
It is diagnosed most often in children and adults under age 40 and often occurs with other congenital heart defects, such as:
Symptoms of aortic coarctation can vary based on how narrow the aorta is and your age.
Half of newborns born with aortic coarctation will show symptoms within the first days of life.
Newborn symptoms include:
In severe cases, babies may develop heart failure and shock.
If the coarctation is mild, you may not experience any symptoms, or it may not be diagnosed until later in childhood.
In children with severe coarctation, symptoms may include:
People with mild aortic coarctations may not develop symptoms until their teens or even later.
Symptoms may include:
Or there may be no symptoms at all.
If symptoms are severe, coarctation of the aorta is often diagnosed soon after birth. When symptoms are mild or absent, the condition may not be diagnosed until later in life.
A health care provider can diagnose coarctation during a physical examination. They may hear a heart murmur with a stethoscope or take different blood pressure readings between the upper and lower body with a blood pressure cuff.
Your provider might run other tests to confirm the diagnosis and show the location and severity of the coarctation.
These more detailed views of the heart can include:
No matter the person’s age at diagnosis, they’ll need treatment for aortic coarctation once symptoms appear. Treatment for aortic coarctation may vary depending on the severity of the condition. If other congenital heart defects are present, your care team may choose to repair all of them at once.
Treatment options may include:
Newborns with symptoms usually have surgery as soon as possible after birth. Most children who show symptoms also will need surgery. If symptoms are mild, more time can be taken to plan for surgery.
During surgery, the narrowed part of the aorta will be removed. It can be repaired or patched with:
In this minimally invasive approach done in the cath lab:
Narrowing or coarctation of the artery can return after surgery. This condition is more likely in people who had surgery as a newborn. Even after surgery, children may still need to be treated with medication to control high blood pressure.
For this reason, people with congenital heart disease should see a congenital heart disease specialist throughout their lives to continually monitor their condition.
Young patients with aortic coarctation may be diagnosed and treated at the Heart Institute at UPMC Children’s Hospital of Pittsburgh. As they age, they can be treated at the UPMC Children's Adult Congenital Heart Disease (ACHD) Center throughout their lifetimes. The center provides advanced treatments, access to the latest clinical trials, and minimally invasive options for qualifying patients.
Adults who receive an aortic coarctation diagnosis may access the specialists at the UPMC Heart and Vascular Institute's Center for Aortic Disease. Our team has experience treating a range of conditions affecting the aorta. This unique center brings together adult congenital heart disease experts, cardiac surgeons, vascular surgeons, and experts from other disciplines to treat patients with aortic disease throughout their lives.
At UPMC:
By UPMC Editorial Staff. Last reviewed on 2024-10-11.
