Coarctation of the Aorta
Definition
Discrete narrowing of the distal segment of the aortic arch
Types
- Pre-ductal
- Post-ductal
Cardiac Auscultation
- Systolic murmur, may be best heard at the left upper back
Electrocardiogram
- Left ventricular hypertrophy
- Left atrial enlargement
Chest X-ray
- "Rib-notching"
- Figure "3" sign
Treatment
- Coarctectation repair
M-Mode
- Left ventricular hypertrophy
- Left atrial enlargement
- Bicuspid aortic valve (associated with coarctation)
2-D
- Suprasternal window is the best view
- Narrowing may be visualized
- Increased pulsation of the aorta may be seen proximal to the lesion
- Increased diameter of the left subclavian artery
- Post-stenotic dilatation may be present
Doppler
- Suprasternal approach is best approach
- PW and color now Doppler may detect increased velocity and turbulent flow at site of obstruction
- CW Doppler determines the peak pressure gradient across coarctation