Difficulties of Diagnosing of Coarctation of Aorta

Aortic coarctation is a congenital heart defect that occurs relatelively often and accounts for 5-8% of all congenital heart defects. It may occur alone or in combination with other defects, mainly - a bicuspid aortic valve and an intraventricular septal defect.

Diagnosing this heart defect may be complicated as clinical manifestation ranges from acute heart failure in infants to hypertension in older childhood and adolescence.

A clinical case of late diagnosis of aortic coarctation in a 12-year-old girl, who presented with severe headache and increased blood pressure of 170/90 mm.Hg. is presented in this poster. The diagnosis of coarctation of aorta was finally confirmed after performing computed tomography, followed by successful repair by balloon dilatation and stenting of the descending aortic arch. In the postoperative period, the girl has secondary hypertension at the level of 140/80 mm Hg.

Conclusions: Depending on the anatomy of the coarctation of aorta, it may clinically manifest in older age by hypertension, as in the described clinical case.

The difficulty of diagnosing this defect was based on the lack of specific auscultatory data (systolic murmur was not heard due to low pressure gradient at narrowing site - 30 mm Hg), therefore pediatricians and family physicians should be aware of this disease and remember about the diagnostic importance of routine monitoring of blood pressure in children older than 3 years, and palpation of the pulsation in the area of the femoral artery during a general pediatric examination, which is absent or weakened in case of presence of the coarctation of the aorta.