![]() A: Ductal coarctation, B: Preductal coarctation, C: Postductal coarctation. ![]() LocationThere are three type of aortic coarctations:Schematic drawing of alternative locations of a coarctation of the aorta, relative to the ductus arteriosus. ![]() This abnormality predisoposes to dissection or rupture in the area of the coarctation. Other cardiac anomalies including PDA and VSD may be associated, and the most important associated noncardiac abnormality is intracerebral aneurysm.Pathological findings include medial thickening and intimal hyperplasia forming a ridge that encircles the aortic lumen. There is an association with a bicuspid aortic valve with a reported incidence of 30-40% or more. Mean age for repair of a significant coarctation is around 17 years of age, thus detection by general pediatricians is very important.One-third of Turner's syndrome (XO) patients have a coarctation. Popliteal arteries (press on the posterior aspect of the tibial plateau in the popliteal fossa).IntroductionCoarctation of the aorta comprises 5-8% of all congenital heart disease, occurring 2-5 times more often in males than females.Examine for radiofemoral delay: palpate radial and femoral pulses together (if there is a big delay between them = 'coarctation'/narrowing of the aorta distal to subcalvian arteries) Femoral arteries (at mid-inguinal point - the point halfway along a line between the anterior superior iliac spine and the top of the pubic symphysis).Examine the abdomen for an abdominal aortic aneurysm (just above umbilicus, push gently).Carotid pulse (between trachea and anterior border of sternocleidomastoid).Brachial pulse (medial aspect of cubital fossa).Look for: radio-radial delay (indicating coarctation proximal to left subclavian), irregular rhythm (irregularly irregular - ?AF, regularly irregular - ?heart block) Radial pulse (lateral flexor aspect of wrist).Record as normal (+), reduced (+/-), absent (-) or aneurysmal if pulsitile AND expansitile. ![]() ![]()
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