Coarctation of the aorta is a narrowing of the aorta between the upper-body artery branches and the branches to the lower body. This blockage can increase blood pressure in your arms and head, reduce pressure in your legs and seriously strain your heart.

Often a coarctation develops during the first few weeks of life. Many babies have no symptoms at all, while others may develop rapid breathing, poor feeding or poor growth. Children who do not have signs of heart problems in the newborn period may not be diagnosed until much later in life, even in their teens or early adulthood, which they may be identified because of high blood pressure in their arms on physical examination.

In children who do not have problems in early infancy, the primary risk of a coarctation is the long-term effects of high blood pressure, or hypertension. Hypertension can, over the years, cause heart failure, coronary artery disease, peripheral vascular disease, strokes and brain aneurysms.

In an otherwise healthy child, coarctation can be repaired surgically with low risk by a surgeon experienced with infant heart surgery, or in some cases without surgery using a special catheter balloon to open the tight area through a blood vessel.

Following repair of coarctation children can have a number of medical problems, including infection and bleeding in the immediate postoperative period. In addition, high blood pressure can persist after repair, more commonly among children operated on later in life. Many children experience abdominal pain for a period of time after repair. The cause of this is not completely clear, but this symptom should be evaluated promptly to be sure there is no other problem. The repaired area can also become tight again (re-coarctation) due to scarring in the region of the repair. This complication is more common among children who undergo surgery in the first months of life, but often such a re-coarctation can be remedied with the balloon catheter technique mentioned above without a second operation. Any child who has the following signs or symptoms following surgery should consult their cardiologist without delay:

• Fever
• Rapid or difficult breathing
• Extreme irritability
• Loss of appetite or vomiting
• Bleeding at the site of surgery
• Bleeding in bowel movements
• Severe abdominal or back pain
• High blood pressure
• Headache, dizziness or fainting

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