A narrowing of the aorta, usually near the ductus arteriosus, causing high blood pressure in the upper body and low blood flow to the lower body.
More Common in Males (2:1 Male-to-Female Ratio)
Associated with:
- Bicuspid Aortic Valve (50%)
- Berry Aneurysms (Cerebral Aneurysms)
- Turner Syndrome (XO Female)
Mnemonic: "CoA = Constriction of Aorta"
CAUSES OF CoA
• Congenital (Present from Birth) → Most Common
• Acquired (Rare) → Takayasu’s Arteritis, Trauma
Mnemonic: "CoA = C.T." (Congenital, Takayasu’s)
SYMPTOMS OF CoA
• Mild Cases (Asymptomatic for Years)
• Severe Cases (Newborns with Heart Failure)
- Headaches & Nosebleeds (High BP in
Upper Body)
- Leg Weakness & Cramps (Low BP in
Lower Body)
- Cold Feet & Delayed Femoral Pulses
Mnemonic: "HIGH-LOW" (CoA Symptoms)
- HIGH BP (Headache, Nosebleeds, Strong
Radial Pulses)
- LOW BP (Leg Weakness, Cold Feet, Weak
Femoral Pulses)
BLOOD PRESSURE
DIFFERENCE IN CoA
- High BP in Arms & Low BP in Legs
- Delayed Femoral Pulses Compared to Radial Pulses (Radial-Femoral Delay)
Mnemonic: "Radial Runs, Femoral Fails"
HEART MURMUR IN
CoA
- Systolic Murmur (Best Heard on Back – Between Shoulder Blades)
- Collaterals Develop (Internal Mammary & Intercostal Arteries) → Rib Notching on X-ray
Mnemonic: "Back Murmur & Rib Notching"
COMPLICATIONS OF
CoA
- Heart Failure (LV Failure)
- Stroke (Cerebral Aneurysm Rupture)
- Aortic Dissection (Tear in Aorta Wall)
Mnemonic: "H.A.S." (Heart Failure, Aneurysm, Stroke)
DIAGNOSIS OF CoA
- Chest X-ray → "3 Sign" (Aortic Indentation), Rib Notching
- ECG → Left Ventricular Hypertrophy (LVH)
- Echocardiography (ECHO – Best Test!) → Confirms CoA
- MRI or CT Angiography → Best for Aortic Anatomy
Mnemonic: "ECHO-3-MRI" (Tests for CoA)
TREATMENT OF CoA
1. MEDICAL
TREATMENT (Before Surgery)
- Beta-Blockers or ACE Inhibitors → Lower BP
- Prostaglandin (PGE1) in Neonates → Keeps Ductus Open
2. SURGICAL
TREATMENT
- Balloon Angioplasty (For Mild Cases or Recurrence)
- Surgical Resection (For Severe Cases)
Mnemonic: "B.P.S." (Beta-Blockers, Prostaglandin, Surgery)
PROGNOSIS OF CoA
- Good if Treated Early
- Late Repair → Persistent Hypertension & Stroke Risk
Mnemonic: "CoA = Correct Early"
FINAL REVISION WITH MNEMONICS
- CoA = "Constriction of Aorta"
- Causes = "C.T." (Congenital, Takayasu’s Arteritis)
- Symptoms = "HIGH-LOW" (High BP in Arms, Low BP in Legs)
- BP Difference = "Radial Runs, Femoral Fails"
- Murmur & X-ray = "Back Murmur & Rib Notching"
- Complications = "H.A.S." (Heart Failure, Aneurysm, Stroke)
- Diagnosis = "ECHO-3-MRI"
- Treatment = "B.P.S." (Beta-Blockers, Prostaglandin, Surgery)
- Prognosis = "CoA = Correct Early"
Tags
PRACTICE OF MEDICINE