Coarctation of the aorta

aortic coarctationcoarctation of aortacoarctationcoarctioncoronary artery blockagenarrow aortaSevere coarctation of the aorta
Coarctation of the aorta (CoA or CoAo), also called aortic narrowing, is a congenital condition whereby the aorta is narrow, usually in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts.wikipedia
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Interrupted aortic arch

Physiologically its complete form is manifested as interrupted aortic arch.
In a sense it is the complete form of a coarctation of the aorta.

Notching of the ribs

3) Postductal coarctation: The narrowing is distal to the insertion of the ductus arteriosus. Even with an open ductus arteriosus, blood flow to the lower body can be impaired. This type is most common in adults. It is associated with notching of the ribs (because of collateral circulation), hypertension in the upper extremities, and weak pulses in the lower extremities. Postductal coarctation is most likely the result of the extension of a muscular artery (ductus arteriosus) into an elastic artery (aorta) during fetal life, where the contraction and fibrosis of the ductus arteriosus upon birth subsequently narrows the aortic lumen.
Inferior rib notching can be associated with aortic coarctation (as a result of dilatation of intercostal arteries ), superior vena caval obstruction, arteriovenous fistula, or following a Blalock Taussig shunt.

Turner syndrome

45,Xmonosomy XTurner
1) Preductal coarctation: The narrowing is proximal to the ductus arteriosus. Blood flow to the aorta that is distal to the narrowing is dependent on the ductus arteriosus; therefore severe coarctation can be life-threatening. Preductal coarctation results when an intracardiac anomaly during fetal life decreases blood flow through the left side of the heart, leading to hypoplastic development of the aorta. This is the type seen in approximately 5% of infants with Turner syndrome.
Coarctation of the aorta

Aorta

aorticaortic archaortic root
Coarctation of the aorta (CoA or CoAo), also called aortic narrowing, is a congenital condition whereby the aorta is narrow, usually in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts. The characteristic bulging of the sign is caused by dilatation of the aorta due to an indrawing of the aortic wall at the site of cervical rib obstruction, with consequent poststenotic dilatation.
Aortic coarctation – pre-ductal, post-ductal

Hypertension

high blood pressurehypertensivearterial hypertension
3) Postductal coarctation: The narrowing is distal to the insertion of the ductus arteriosus. Even with an open ductus arteriosus, blood flow to the lower body can be impaired. This type is most common in adults. It is associated with notching of the ribs (because of collateral circulation), hypertension in the upper extremities, and weak pulses in the lower extremities. Postductal coarctation is most likely the result of the extension of a muscular artery (ductus arteriosus) into an elastic artery (aorta) during fetal life, where the contraction and fibrosis of the ductus arteriosus upon birth subsequently narrows the aortic lumen.
Coarctation of the aorta frequently causes a decreased blood pressure in the lower extremities relative to the arms, or delayed or absent femoral arterial pulses.

Clarence Crafoord

The first operations to treat coarctation were carried out by Clarence Crafoord in Sweden in 1944.
Clarence Crafoord (1899 – 1984) was a Swedish cardiovascular surgeon, best known for performing the first successful repair of aortic coarctation on 19 October 1944, one year before Robert E. Gross.

Cardiac surgery

open heart surgeryheart surgeryopen-heart surgery
Surgery on the great vessels (e.g., aortic coarctation repair, Blalock–Thomas–Taussig shunt creation, closure of patent ductus arteriosus) became common after the turn of the century.

Bicuspid aortic valve

bicuspid valvecongenitally have two leaflets
People who have had a coarctation of the aorta are likely to have bicuspid aortic valve disease.
Coarctation of the aorta (a congenital narrowing in the region of the ductus arteriosus) has also been associated with BAV.

Ductus arteriosus

ductus arteriosisductal
1) Preductal coarctation: The narrowing is proximal to the ductus arteriosus. Blood flow to the aorta that is distal to the narrowing is dependent on the ductus arteriosus; therefore severe coarctation can be life-threatening. Preductal coarctation results when an intracardiac anomaly during fetal life decreases blood flow through the left side of the heart, leading to hypoplastic development of the aorta. This is the type seen in approximately 5% of infants with Turner syndrome. Coarctation of the aorta (CoA or CoAo), also called aortic narrowing, is a congenital condition whereby the aorta is narrow, usually in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts.

Ligamentum arteriosum

Coarctation of the aorta (CoA or CoAo), also called aortic narrowing, is a congenital condition whereby the aorta is narrow, usually in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts.

Ventricle (heart)

ventricleleft ventricleright ventricle
When a patient has a coarctation, the left ventricle has to work harder.

Aortic stenosis

aortic valve stenosisAorticstenosis
Aortic coarctation and aortic stenosis are both forms of aortic narrowing.

Usage (language)

usageusedlanguage usage
In terms of word root meanings, the names are not different, but a conventional distinction in their usage allows differentiation of clinical aspects.

Discretization

discretizeddiscretizingdichotomization
This spectrum is dichotomized by the idea that aortic coarctation occurs in the aortic arch, at or near the ductus arteriosis, whereas aortic stenosis occurs in the aortic root, at or near the aortic valve.

Aortic valve

aorticaortic valvesaortic semilunar valve
This spectrum is dichotomized by the idea that aortic coarctation occurs in the aortic arch, at or near the ductus arteriosis, whereas aortic stenosis occurs in the aortic root, at or near the aortic valve.

Intermittent claudication

claudication intermittensvascular claudication
They have cold legs and feet or have pain in their legs with exercise (intermittent claudication).

Subclavian artery

subclavian arteriesleft subclavian arterysubclavian
The coarctation typically occurs after the left subclavian artery.

Neurovascular bundle

nerves, arteries, or veinsneurovascular
With imaging, resorption of the lower part of the ribs may be seen, due to increased blood flow over the neurovascular bundle that runs there.

X-ray

x-rayssoft x-rayx rays
Prestenotic dilatation of the aortic arch and left subclavian artery, as well as indentation at the site of coarctation results in a classic 'figure 3 sign' on x-ray.

Cervical rib

cervical ribscervical rib syndromecervical
The characteristic bulging of the sign is caused by dilatation of the aorta due to an indrawing of the aortic wall at the site of cervical rib obstruction, with consequent poststenotic dilatation.

Magnetic resonance angiography

magnetic resonance angiogramMRAmagnetic resonance
Coarctation of the aorta can be accurately diagnosed with magnetic resonance angiography.

Echocardiography

echocardiogramechocardiographicultrasound of the heart
In teenagers and adults echocardiograms may not be conclusive.

Body surface area

body surfacebody surface area (BSA)body surfaces
The severity of coarctation of the aorta can be rated by a combination of the smallest aortic cross-sectional area of the aorta (adjusted for body surface area) as measured by 3D-rendered contrast MRI, as well as mean heart rate–corrected flow deceleration in the descending aorta as measured by phase contrast magnetic resonance imaging.

MRI contrast agent

gadolinium-based MRI contrast agentcontrast agentsenhanced
The severity of coarctation of the aorta can be rated by a combination of the smallest aortic cross-sectional area of the aorta (adjusted for body surface area) as measured by 3D-rendered contrast MRI, as well as mean heart rate–corrected flow deceleration in the descending aorta as measured by phase contrast magnetic resonance imaging.

Descending aorta

descending thoracic aortadorsal aortaproximal descending aorta
The severity of coarctation of the aorta can be rated by a combination of the smallest aortic cross-sectional area of the aorta (adjusted for body surface area) as measured by 3D-rendered contrast MRI, as well as mean heart rate–corrected flow deceleration in the descending aorta as measured by phase contrast magnetic resonance imaging.