Aortic coarctation
Aortic coarctation is narrowing of the aorta in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts.
Types
There are two types: Preductal coarctation: this occurs in children, with an increased risk in Turner syndrome. The word preductal means that the narrowing is anterior to the ligamentum arteriosum. Post-ductal coarctation: this is mainly seen in adults.
Signs, symptoms and diagnosis
Arterial hypertension in the left arm with normal to low blood pressure in the right arm is classic. Poor peripheral pulses, especially of with right carotid artery and the femoral arteries, may be found in severe cases. On chest X-ray, resorption of the lower part of the ribs may be seen, due to increased blood flow over the neurovascular bundle that runs there.
Therapy
Therapy is conservative if asymptomatic, but may require surgical resection of the narrow segment if there is arterial hypertension.
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