![]() ![]() Surgical relief of coarctation may be achieved by resection and end-to-end anastomosis or by subclavian flap or prosthetic path angioplasty. Aortic coarctation may be relieved by surgery or by balloon angioplasty in asymptomatic patients, therapy during the ages of 2 and 5 years is suggested. Cardiac catheterization shows significant peak-to-peak systolic pressure gradient across the coarcted segment, and aortography demonstrates the degree and nature of the aortic narrowing. The coarctation can be demonstrated on suprasternal notch two-dimensional echocardiographic views along with increased Doppler flow velocity across the coarctation site. On measurement of blood pressure from arms and legs, a pressure difference of more than 20 mm Hg in favor of the arms may be considered as evidence for coarctation of the aorta. ![]() Palpation of the brachial and femoral pulses simultaneously will show decreased and delayed or absent femoral pulses. Children beyond infancy are usually asymptomatic and are most often diagnosed because of a murmur or hypertension on a routine examination. Neonates and infants, especially when they have other associated cardiac defects, may present with signs and symptoms of heart failure. The prevalence of aortic coarctation varies from 5% to 8% of all congenital heart defects. ![]() Coarctation of the aorta is an important and treatable cause of secondary hypertension.
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