iPedia Free Information Center

Information about Aortic Coarctation


Classification & external resources
ICD-10Q25.1
ICD-9747.10
OMIM120000
DiseasesDB2876
eMedicinemed/154 
MeSHD001017


Aortic coarctation is narrowing of the aorta in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts.

Types

There are three types:[1]
  1. Preductal coarctation: The narrowing is proximal to the ductus arteriosus. If severe, blood flow to the aorta distal (to lower body) to the narrowing is dependent on a patent ductus arteriosus, and hence its closure can be life-threatening.
  2. Ductal coarctation: The narrowing occurs at the insertion of the ductus arteriosus. This kind usually appears when the ductus arteriosus closes.
  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. Newborns with this type of coarctation may be critically sick from the birth.

Signs and symptoms

Arterial hypertension in the right arm with normal to low blood pressure in the lower extremities is classic. Poor peripheral pulses in the femoral arteries may be found in severe cases.

If the coarctation is situated before the left subclavian artery, asynchronous radial pulses will be detected in the right and left arms. A radial-femoral delay between the right arm and the femoral artery would be apparent, whilst no such delay would occur under left arm radial-femoral palpation.

A coarctation occurring after the left subclavian artery will produce synchronous radial pulses, but radial-femoral delay will be present under palpation in either arm.

Imaging and diagnosis

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. Post-stenotic dilation of the aorta results in a classic 'reverse 3 sign' on x-ray. 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 post-stenotic dilation. This physiology results in the reversed '3' image for which the sign is named.[2][3][4]

Coarctation of the aorta can be accurately diagnosed with magnetic resonance angiography. In teenagers and adults echocardiograms may not be conclusive. In adults with untreated coarctation blood often reaches the lower body through collaterals, eg. internal thoracic arteries via. the subclavian arteries. Those can be seen on MR or angiography. An untreated coarctation may also result in hypertrophy of the left ventricle.

A case of coarctation of the aorta was published in the New England Journal of Medicine in 2007 showing chest X-Rays and MRT Images.[5]

Therapy

Therapy is conservative if asymptomatic, but may require surgical resection of the narrow segment if there is arterial hypertension. In some cases angioplasty can be performed to dilate the narrowed artery. If the coarctation is left untreated, arterial hypertension may become permanent due to irreversible changes in some organs (such as the kidney).

References

1. ^ Valdes-Cruz LM, Cayre RO: Echocardiographic diagnosis of congenital heart disease. Philadelphia, 1998.
2. ^ Sabatine, Marc (February 15, 2000). Pocket Medicine. Lippincott Williams & Wilkins, 256 pages. ISBN 0781716497. 
3. ^ Blecha, Matthew J. (August 30, 2005). General Surgery ABSITE and Board Review (Pearls of Wisdom). McGraw-Hill.
4. ^ Brady Pregerson (October 1, 2006). Quick Essentials: Emergency Medicine, 2nd Edition. ED Insight Books.
5. ^ Quiros-Lopez R, Garcia-Alegria J (2007). "A medical mystery -- high blood pressure". N Engl J Med 356 (25): 2630. PMID 17582073. 

External links

 •  • [ e]
Congenital malformations and deformations of circulatory system (, )
Cardiac chambers and connectionsPersistent truncus arteriosus - Double outlet right ventricle - Taussig-Bing syndrome - Transposition of the great vessels (dextro, levo)
Cardiac septaVentricular septal defect - Atrial septal defect (Lutembacher's syndrome) - Atrioventricular septal defect - Tetralogy of Fallot - Eisenmenger's syndrome
Pulmonary and tricuspid valvesPulmonary valve stenosis - Tricuspid atresia - Ebstein's anomaly
Aortic and mitral valvesAortic valve stenosis - Aortic insufficiency - Bicuspid aortic valve - Mitral stenosis - Mitral regurgitation - Hypoplastic left heart syndrome
Other congenital malformations
of heart		Dextrocardia - Levocardia - Cor triatriatum
Great arteriesPatent ductus arteriosus - Aortic coarctation - Overriding aorta - Aneurysm of sinus of Valsalva - Pulmonary atresia
Great veinsPersistent left superior vena cava - Total anomalous pulmonary venous connection - Scimitar syndrome
OtherArteriovenous malformation (Cerebral arteriovenous malformation)
See also conditions (, )
For other uses of "ICD", see ICD (disambiguation).


The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
..... Click the link for more information.
List of ICD-10 codes. The version for 2007 is available online at [1]

Chapter Blocks Title
I Certain infectious and parasitic diseases
II Neoplasms
III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
..... Click the link for more information.
For other uses of "ICD", see ICD (disambiguation).


The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
..... Click the link for more information.
The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. These codes are in the public domain.

See also


..... Click the link for more information.
The Diseases Database is a free website that provides information about the relationships between medical conditions, symptoms, and medications.

It directly integrates the Unified Medical Language System.

External links

  • Diseases Database

..... Click the link for more information.
eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely, two medical doctors. It was sold to WebMD in January 2006.
..... Click the link for more information.
Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. Created and updated by the United States National Library of Medicine (NLM), it is used by the MEDLINE/PubMed
..... Click the link for more information.
The aorta (generally pronounced [eɪˈɔːtə] or "ay-orta") is the largest artery in the human body, originating from the left ventricle of the heart and bringing oxygenated blood to all parts of the body in the systemic circulation.
..... Click the link for more information.
In the developing fetus, the ductus arteriosus (DA) is a shunt connecting the pulmonary artery to the aortic arch that allows most of the blood from the right ventricle to bypass the fetus' fluid-filled lungs.
..... Click the link for more information.
The ligamentum arteriosum is a small ligament attached to the superior surface of the pulmonary trunk and the inferior surface of the aortic arch. It is a nonfunctional vestige of the ductus arteriosus, and is formed within three weeks of birth.
..... Click the link for more information.
Hypertension
Classification & external resources

ICD-10 I 10. ,I 11. ,I 12. ,
I 13. ,I 15.
ICD-9 401.x

OMIM 145500
DiseasesDB 6330
MedlinePlus 000468
eMedicine med/1106   ped/1097 emerg/267


..... Click the link for more information.
A Neurovascular bundle (Neuro: Nerve, Vascular: Veins, Lymph vessels and arteries) is a term applied to the body nerves, arteries, veins and lymphatics that tend to travel together in the body.
..... Click the link for more information.
X-rays (or Röntgen rays) are a form of electromagnetic radiation with a wavelength in the range of 10 to 0.01 nanometers, corresponding to frequencies in the range 30 PHz to 30 EHz. X-rays are primarily used for diagnostic radiography and crystallography.
..... Click the link for more information.
The aorta (generally pronounced [eɪˈɔːtə] or "ay-orta") is the largest artery in the human body, originating from the left ventricle of the heart and bringing oxygenated blood to all parts of the body in the systemic circulation.
..... Click the link for more information.
In anatomy, 'cervical' is an adjective that has two meanings:
  1. of or pertaining to any neck.
  2. of or pertaining to the female cervix: i.e., the neck of the uterus.
  • Commonly used medical phrases involving the neck are...

..... Click the link for more information.
RIB can mean:
  • Rigid-hulled inflatable boat
  • Romanian International Bank
  • Routing Information Base
This article is about the bones called ribs. For other meanings, see rib (disambiguation).

..... Click the link for more information.
Magnetic Resonance Angiography is the imaging of blood vessels using Magnetic Resonance Imaging. Magnetic Resonance Angiography (MRA) is used to generate pictures of the arteries in order to evaluate them for stenosis (abnormal narrowing) or aneurysms (vessel wall dilatations, at
..... Click the link for more information.
An echocardiogram is an ultrasound of the heart. Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart. The latest ultrasound systems now employ 3D real-time imaging.
..... Click the link for more information.
Angiography or arteriography is a medical imaging technique in which an X-ray picture is taken to visualize the inner opening of blood filled structures, including arteries, veins and the heart chambers.
..... Click the link for more information.
The New England Journal of Medicine (New Engl J Med or NEJM) is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It is one of the most popular and widely-read peer-reviewed general medical journals in the world.
..... Click the link for more information.
Hypertension
Classification & external resources

ICD-10 I 10. ,I 11. ,I 12. ,
I 13. ,I 15.
ICD-9 401.x

OMIM 145500
DiseasesDB 6330
MedlinePlus 000468
eMedicine med/1106   ped/1097 emerg/267


..... Click the link for more information.
Intervention:


ICD-10 code:
ICD-9 code: 00.6

Other codes: Angioplasty is the mechanical widening of a narrowed or totally-obstructed blood vessel. These obstructions are often caused by atherosclerosis.
..... Click the link for more information.
Hypertension
Classification & external resources

ICD-10 I 10. ,I 11. ,I 12. ,
I 13. ,I 15.
ICD-9 401.x

OMIM 145500
DiseasesDB 6330
MedlinePlus 000468
eMedicine med/1106   ped/1097 emerg/267


..... Click the link for more information.
The kidneys are organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. The medical field that studies the kidneys and diseases of the kidney is called nephrology[1].
..... Click the link for more information.
August 30 is the 1st day of the year (2nd in leap years) in the Gregorian calendar. There are 0 days remaining.

Events

  • 1574 - Guru Ram Das became the Fourth Sikh Guru/Master.

..... Click the link for more information.
20th century - 21st century - 22nd century
1970s  1980s  1990s  - 2000s -  2010s  2020s  2030s
2002 2003 2004 - 2005 - 2006 2007 2008

2005 by topic:
News by month
Jan - Feb - Mar - Apr - May - Jun
..... Click the link for more information.
Eastern (Byzantine) Catholic Church - Patronage/Protection of the Theotokos (Virgin Mary, Mother of God) dating to 10th Century Constantinople, when she appeared holding her mantle over the faithful who were praying in a church during a military attack on the city.
..... Click the link for more information.
20th century - 21st century - 22nd century
1970s  1980s  1990s  - 2000s -  2010s  2020s  2030s
2003 2004 2005 - 2006 - 2007 2008 2009

2006 by topic:
News by month
Jan - Feb - Mar - Apr - May - Jun
..... Click the link for more information.
A congenital disorder is any medical condition that is present at birth. However, a congenital disorder can be recognized before birth (prenatally), at birth, years later, or never. The term congenital does not imply or exclude a genetic cause.
..... Click the link for more information.
Circulatory System is a psychedelic rock musical ensemble formed by musician/painter Will Cullen Hart, and featuring Hannah Jones, Derek Almstead, Peter Erchick, John Fernandes, and Heather McIntosh.
..... Click the link for more information.


This article is copied from an article on Wikipedia.org - the free encyclopedia created and edited by online user community. The text was not checked or edited by anyone on our staff. Although the vast majority of the wikipedia encyclopedia articles provide accurate and timely information please do not assume the accuracy of any particular article. This article is distributed under the terms of GNU Free Documentation License.
Herod_Archelaus


page counter