Aortic coarctation is a narrowing of part of the aorta, the artery that sends oxygenated blood from the heart to the rest of the body. Many people with this condition will not have symptoms until later in life.

When the aorta is too narrow, it restricts blood flow to the lower part of the body and increases blood pressure above the narrowing. This means your heart has to work harder to circulate blood to the rest of the body. As a result of the increased work, the heart wall initially thickens, a condition called hypertrophy. If the coarctation is not corrected, heart failure may develop.

One of the symptoms of congestive heart failure is breathlessness. If you were born with aortic coarctation, you may have other heart abnormalities such as deformed aortic valves, patent ductus arteriosus or ventricular septal defect.

High blood pressure above the narrowing also can result in high blood pressure in the arteries that branch out from the aorta, including those in the arms and brain. This can lead to hypertension resulting in stroke, congestive heart failure and complications of coronary artery disease.

Below the narrowing, the blood pressure may be too low and cause problems feeding enough blood into organs such as the kidneys.

Symptoms of aortic coarctation include:

• Difficulty breathing with exertion, called exertional dyspnea
• Headaches
• Nose bleeds, called epistaxis
• Leg fatigue and cramps

In untreated patients younger than 30 years old, aortic rupture and cerebral hemorrhage are the most common complications. After age 40, the incidence of congestive heart failure increases.

Therapy is conservative if asymptomatic, but may require surgical resection of the narrow segment if there is arterial hypertension. In some cases angioplasty can be performed to dilate the narrowed artery.

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