1. Symptoms of aortic coarctation
2. Treatment of aortic coarctation
coarctation of the aorta - a limited segmental narrowing of the aorta, leading to high blood pressure in the blood vessels of the upper extremities,insufficient blood supply to the lower limbs and abdominal organs, hypertrophy of the left ventricle of the heart.
In this pathology accounts for 8% to 10% of all congenital heart defects.In boys, it occurs twice as often than girls.Coarctation of the aorta in children may be an isolated defect, and may be accompanied by a number of other congenital anomalies (ventricular septal defect, patent ductus arteriosus, bicuspid valve abnormality of the mitral valve, aortic stenosis, cerebral aneurysm).
In rare cases occurs coarctation of the abdominal aorta.
physiological consequences of this pathology is to increase the load on the left ventricle and hypertrophy, increased blood flow to the upper part of the body, including the brain, insufficient blood supply of the
Depending on the length of the narrowed area of the aorta and the degree of narrowing of the aortic coarctation symptoms can vary considerably.Patients may experience chest pain and headache, feel weak, complain about the cold lower limbs, and lameness.In severe cases may develop heart failure and shock.
are two types of this pathology:
- I type - isolated coarctation (typical for adults);
- II type - pathology, combined with patent ductus arteriosus (typical for children).
second type of coarctation particularly dangerous because it is accompanied by the formation of early pulmonary hypertension.Narrow aorta makes the bloodstream from the heart to the lower body defective, while blood pressure rises above the narrowing portion.This leads to the following symptoms of aortic coarctation site:
- the formation of "athletic" physique.Patients well developed shoulder girdle, but the weak lower limbs;
- nosebleeds and headaches.This symptom is caused by hypertension.
- pain in the chest.
natural course blemish may be accompanied by secondary fibroelastosis myocardial and endocardial left ventricular coronary artery disease, cerebral circulation or bleeding in the brain disorders.These complications have a negative impact on the result of the delayed surgery of aortic coarctation.
With strong narrowing section of the aorta in infants may develop renal insufficiency on the background of circulatory shock and metabolic acidosis, the clinical manifestations are similar to other systemic diseases (eg, sepsis).Neonates developing heart failure.
In the case of less severe coarctation of the aorta in children clinical manifestations of disease may not be available during the first year of life.But as the child grows he may experience symptoms of aortic coarctation as a general weakness, headache, lameness with increasing physical activity.Unlike infants, older children heart failure is rare, as rare cases are rupture of a brain aneurysm and intracranial hemorrhage.
Untreated aortic coarctation in adulthood leads to the development of left ventricular heart failure, intracranial hemorrhage, hypertension, hypertensive encephalopathy, aortic rupture.
operative treatment of this pathology.In case of severe disease in newborns, coarctation of the aorta surgery should be done as early as possible.
When observed during a mild defect, coarctation of the aorta surgical treatment is considered appropriate to postpone until such time as little patient be fulfilled 6-15 years.Such a decision is taken to prevent recurrence at the site of coarctation correction.
The aim of surgery is the resection of the narrowed area of the aorta with a synthetic overlay patch at the site.
preoperative patients can be assigned blockers to treat hypertension.For correction of hypertension after surgery of aortic coarctation patients prescribed blockers, ACE inhibitors or angiotensin II receptor blockers.
All patients, regardless of whether they had surgery for the correction of aortic constriction or not, prior to any surgical or dental procedures under which it is possible the development of bacteremia, endocarditis prophylaxis must be obtained.
This article is available exclusively in the educational purposes and is not research material or professional medical advice.
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