Aortic coarctation

• aortic isthmus narrows

• 5% of CHD cases

• 4:1, males:females

• leg BP < arm BP—it’s important to measure BP in the arms and the legs because this is a very quick way to identify aortic coarctation

• bicuspid aortic valve in 50% of cases; the valve may or may not be stenotic

• variable left ventricular hypertrophy

• rib notching on chest radiographs

types of aortic coarcts

• preductal: infantile type: less common, early onset of symptoms, requires surgery

• postductal: adult type: less severe; might be asymptomatic and undetected until adulthood

• this distinction is general; physiological features dictate treatment

diagram of aortic coarctation

• ductus arteriosus is the continuation of 6^th aortic arch in embryology

• postductals are below the ductus

• preductals are above the ductus

gross specimen

• ductus arteriosus and notching of the aorta can be seen

• this is a preductal coarct because the notch is upstream of the ductus arteriosus

• LV is very hypertrophied

another gross specimen

• this isn’t a symmetric narrowing but rather a notching formed when the fourth and sixth aortic arches came together and fused abnormally

Category: Pathology Notes