Coarctation of the aorta - Revision history

Danbot: Add MedicationDose entries for PGE1, furosemide, dopamine, dobutamine

2026-03-20T21:10:36Z

Add MedicationDose entries for PGE1, furosemide, dopamine, dobutamine

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 ==Disposition==
 *Admit
 ==See Also==

Rossdonaldson1: /* Evaluation */

2024-11-13T16:55:34Z

Evaluation

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	==Evaluation==		==Evaluation==
	[[File:Coarctation CXR.jpg\|thumb\|]]		[[File:Coarctation CXR.jpg\|thumb\|Chest x-ray showing classic findings for coarctation of the aorta.]]
	[[File:1440px-Co.A. 01- 4 M Kind - Z. n. End-zu-End.jpg\|thumb\|Coarctation of the aorta on cath.]]		[[File:1440px-Co.A. 01- 4 M Kind - Z. n. End-zu-End.jpg\|thumb\|Coarctation of the aorta on cath.]]
	*[[CXR]]		*[[CXR]]

Rossdonaldson1: /* Evaluation */

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Evaluation

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	==Evaluation==		==Evaluation==
	[[File:Coarctation CXR.jpg\|thumb\|~~Coarctation of the aorta on cath.~~]]		[[File:Coarctation CXR.jpg\|thumb\|]]
	[[File:1440px-Co.A. 01- 4 M Kind - Z. n. End-zu-End.jpg\|thumb]]		[[File:1440px-Co.A. 01- 4 M Kind - Z. n. End-zu-End.jpg\|thumb\|Coarctation of the aorta on cath.]]
	*[[CXR]]		*[[CXR]]
	**Rib notching due to collateral blood vessels		**Rib notching due to collateral blood vessels

Rossdonaldson1: /* Evaluation */

2024-11-13T16:53:42Z

Evaluation

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	==Evaluation==		==Evaluation==
	[[File:Coarctation CXR.jpg\|thumb\|]]		[[File:Coarctation CXR.jpg\|thumb\|Coarctation of the aorta on cath.]]
	[[File:1440px-Co.A. 01- 4 M Kind - Z. n. End-zu-End.jpg\|thumb]]		[[File:1440px-Co.A. 01- 4 M Kind - Z. n. End-zu-End.jpg\|thumb]]
	*[[CXR]]		*[[CXR]]

Rossdonaldson1: /* Evaluation */

2024-11-13T16:49:12Z

Evaluation

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	==Evaluation==		==Evaluation==
	[[File:Coarctation CXR.jpg\|thumb\|]]		[[File:Coarctation CXR.jpg\|thumb\|]]
			[[File:1440px-Co.A. 01- 4 M Kind - Z. n. End-zu-End.jpg\|thumb]]
	*[[CXR]]		*[[CXR]]
	**Rib notching due to collateral blood vessels		**Rib notching due to collateral blood vessels

Rossdonaldson1: /* Background */

2024-11-13T16:44:24Z

Background

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	==Background==		==Background==
	[[File:Coarctation.jpg\|thumb\|]]		[[File:Blausen 0243 CoarctationofAorta CloseUp.png\|thumb\|Coarctation of the aorta.]]
			[[File:Coarctation.jpg\|thumb\|Coarctation of the aorta.]]
	*Narrowing of aorta, most commonly at ductus arteriosus insertion site just distal to left subclavian artery		*Narrowing of aorta, most commonly at ductus arteriosus insertion site just distal to left subclavian artery
	**Less common: diffuse arch hypoplasia with long segment of narrowing proximal to left subclavian<ref>https://newbp.bmj.com/topics/en-gb/698</ref>		**Less common: diffuse arch hypoplasia with long segment of narrowing proximal to left subclavian<ref>https://newbp.bmj.com/topics/en-gb/698</ref>

Blsimpso: /* External Links */

2021-07-01T02:18:47Z

External Links

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	==External Links==		==External Links==
			*[https://www.acep.org/how-we-serve/sections/pediatric-emergency-medicine/pedemmorsels/coarctation-of-the-aorta-in-the-older-child/ ACEP - Coarctation of the Aorta in the Older Child]

	==References==		==References==
	<references/>		<references/>
	[[Category:Pediatrics]] [[Category:Cardiology]]		[[Category:Pediatrics]] [[Category:Cardiology]]

Rossdonaldson1: Rossdonaldson1 moved page Coarctation of the Aorta to Coarctation of the aorta over redirect

2021-05-05T21:43:03Z

Rossdonaldson1 moved page Coarctation of the Aorta to Coarctation of the aorta over redirect

← Revisión anterior	Revisión del 21:43 5 may 2021
(Sin diferencias)

ClaireLewis: Created page with "==Background== thumb| *Narrowing of aorta, most commonly at ductus arteriosus insertion site just distal to left subclavian artery **Less common: diff..."

2019-08-18T16:37:31Z

Created page with "==Background== thumb| *Narrowing of aorta, most commonly at ductus arteriosus insertion site just distal to left subclavian artery **Less common: diff..."

Página nueva

==Background==
[[File:Coarctation.jpg|thumb|]]
*Narrowing of aorta, most commonly at ductus arteriosus insertion site just distal to left subclavian artery
**Less common: diffuse arch hypoplasia with long segment of narrowing proximal to left subclavian<ref>https://newbp.bmj.com/topics/en-gb/698</ref>
*~7% of live births with congenital heart disease <ref> Rosenthal E. Coarctation of the aorta form fetus to adult: curable condition or life long disease process? Heart Nov 2005; 91(11): 1495-1502</ref>
*Associated with bicuspid aortic valve (50%), [[VSD]], [[PDA]]

==Clinical Features==
*Systolic [[murmur]], often conducted to back
*Weak or absent femoral pulses, leg claudication, exercise intolerance
*Upper limb [[hypertension]]
*Usually diagnosed within first year of life, when presentation typically dramatic, particularly after closure of [[PDA]] in ductal-dependant critical coarctations.
**Consider in all critically ill neonates, particularly with poor perfusion to lower extremities
**[[Heart failure]], [[shock]]
*Less severe coarctations may go undiagnosed for years, but can still lead to complications long-term<ref>https://pedemmorsels.com/coarctation-of-the-aorta-in-older-children/</ref>:
**[[Dysrhythmias]]
**[[Heart failure]]
**[[ICH]]
**[[Aortic dissection]]
**Infective [[endocarditis]]

==Differential Diagnosis==
{{Sick neonate DDX}}

==Evaluation==
[[File:Coarctation CXR.jpg|thumb|]]
*[[CXR]]
**Rib notching due to collateral blood vessels
**"Figure 3" sign seen in 50% of patients
**Abnormal aortic knob shadow due to coarct and dilation of left subclavian
*[[EKG]]: LVH +/- LA enlargement
*[[Echocardiography]]
*Cardiac MRI

==Management==
===Neonate in Shock (duct-dependent lesion)===
*[[PGE1]] 0.1mcg/kg/min IV/IO
**Side Effects:
***Apnea (intubate)
****[[Hypotension]]
****Bradycardia
****Flushing
*[[NS]] 10cc/kg
*[[Dobutamine]]

===[[CHF]]===
*[[O2]] (give only if SpO2 <95%)
*[[Furosemide]] 1-2mg/kg IV
*[[Dopamine]] 5-10mcg/kg/min
*[[Dobutamine]] 5-10mcg/kg/min

==Disposition==
*Admit

==See Also==
*[[Congenital heart disease]]
*[[Neonatal resuscitation]]

==External Links==

==References==
<references/>
[[Category:Pediatrics]] [[Category:Cardiology]]