Patient education: Aortic coarctation in children (The Basics)

What is aortic coarctation in children? — Aortic coarctation is a problem that causes the heart's largest vessel, called the "aorta," to narrow (figure 1). Children with aortic coarctation are born with the problem.

What are the symptoms of aortic coarctation in children? — It depends. Often, especially if the narrowing of the aorta is not severe, there are no symptoms. In some cases, it is found before a baby is born, during a "prenatal ultrasound" (a routine imaging test that is done during pregnancy). But often, the narrowing can't be seen very well on prenatal ultrasound, so it is not found until after the baby is born.

Newborn infants with severe narrowing of the aorta might have symptoms that include:

●Pale skin

●Crying and fussing more than normal

●Sweating

●Trouble breathing

Older babies and children with milder narrowing might not have any symptoms. In these cases, the narrowing is only found when a doctor or nurse checks their blood pressure or listens to their heart during a routine check-up. But some children can have symptoms, especially when they are physically active, including:

●Chest pain or leg cramps

●Cold hands and feet

Are there tests for aortic coarctation in children? — Yes. The doctor will do an exam and measure your child's pulse and blood pressure in their arms and legs. Children with this condition have a weaker pulse and lower blood pressure in their legs than in their arms.

Other tests include:

●An electrocardiogram (ECG) – This test measures the electrical activity of the heart.

●An echocardiogram – This test uses sound waves to take pictures of the heart and aorta.

●An MRI or CT scan – These tests take pictures of the heart and aorta.

How is aortic coarctation in children treated? — The treatment will depend on your child's age, size, and symptoms. Newborns with serious symptoms might need medicines given through a thin tube that goes into a vein, called an "IV".

Other treatments include:

●Angioplasty – A doctor puts a thin tube into a blood vessel in the leg or arm and advances the tube to the aorta. Then the doctor inflates a balloon inside the aorta to widen it. In older children, the doctor might prop open the aorta using a mesh tube called a "stent."

●Surgery – Different types of surgery can fix the narrowed aorta. The doctor might remove the narrowed part of the aorta. In other cases, they use a plastic tube called a "graft" or a piece of another one of your child's blood vessels to fix the aorta.

What will my child's life be like? — Many children with aortic coarctation are able to live normal lives. But aortic coarctation can return after treatment. This means your child will need to see their doctor on a regular basis. How often will depend on your child's condition. Also, you should check with your doctor about whether your child should not do certain activities or sports.