Coarctation of the aorta (Narrowing)
Valvular heart disease - severe pathology that can have serious consequences for patients until death. One of such defects - coarctation of the aorta, from which are born some people and even sometimes live to be 30-40 years, because there is a regularity without treatment of the disease decompensation occurs either in the first year of life, or is delayed for three decades.
Infants with this defect develop the phenomenon of heart failure in adult patients, surviving to thirty years, formed various aneurysm of aorta with subsequent rupture. Both scenarios lead to the death of patients, if not timely diagnosis and treatment.
What happens to the aorta at the coarctation
Coarctation is a narrowing of a segment of the thoracic aorta, leading not only to poor circulation as such, but to the forced formation of additional modes in the systemic circulation.
Visually coarctation of the aorta is defined as a constriction of the vessel with the obligatory presence of the diaphragm in the place of narrowing, so the segment of the aorta with a defect resembles a hourglass.
The narrowed area may take from a few millimeters to several centimeters in length, it leaves many collaterals - plus vascular, formed by the body trying to normalize the disturbed circulation.
In the ribs of patients with coarctation of the aorta are also observed specific changes - Uzury, representing the curvature and irregularities of the bottom edge. They are formed due to excessive pressure on the bones of the rib arteries subjected to pathological expansion and izvetia.
Bulging and twisting of the artery in the region of the ribs of a child is one of the obvious symptoms of coarctation of the aorta.
Why develop a coarctation?
Coarctation of the aorta - a congenital, causes the development of which is still only being discussed, but most experts agree that in the process of formation of the vascular system in the fetus is disrupted the fusion of the aortic arches: this leads eventually to the formation of a constriction in one of the segments of the vessel.
There is also a direct link between the pathology of the formation of the aorta and syndrome Shereshevsky-Turner - chromosomal defect in which the fetus remains only one sex chromosome. These children have a genetic predisposition to the coarctation.
Signs and symptoms
Narrowing of the aorta (coarctation) - a diagnosis which may be suspected of watching the newborn to a pediatrician, if the specialist notes the following symptoms:
- The disproportionate figure of the child (the chest is more developed than the lower part, causing the body is "athletic");
- The restlessness of the child's behavior associated with headaches;
- Hypertension in upper extremities and hypotension in the lower.
In examination by the cardiologist revealed changes in the coronary vascular and the left ventricle of the heart. Severe coarctation causes circulatory shock due to the decrease in cardiac output, which is accompanied by the development of renal failure and acidosis (acidification blood).
However, the above symptoms are characteristic mainly for the pronounced narrowing of the aorta.
If coarctation of aorta is weak, it is about pathology say its nonspecific signs:
- Weakness, fatigue;
- When walking a noticeable limp;
- Chest pain.
They can grow as they grow older sick child. Resistant hypertension that accompanies the disease, in rare cases, causes the formation of aneurysms and their subsequent rupture with the development of subarachnoid or intracranial hemorrhage.
Types of coarctation in children
Coarctation of the aorta in children is formed in the childhood and adult types.
Child scenario is the most unfavourable, since this type of coarctation leads to the formation of persistent pulmonary hypertension and heart failure (HF).
The reason for such a severe course of the disease is that above the narrowing of blood pressure is magnified and causes the body to turn on compensatory mechanisms for the discharge of the blood into the left pulmonary artery or descending aorta, which ultimately causes an increase in pressure in the lungs and increase symptoms of SN.
Adult type of the disease is slightly lighter and is considered more favorable because in this variant of the development of coarctation of the aorta is characterized by increased blood pressure only in the upper part of the body of the child. The AD at the bottom of the torso decreases, causing the body has to connect another reserve - renal to try to balance blood pressure.
How to diagnose aortic stenosis
In addition to physical examination patients undergo a number of diagnostic procedures using modern equipment.
- Echocardiographic examination);
- X-rays of the heart and lungs;
- The aortography;
- Catheterization of the heart.
That allowfind out these methods?
So, diagnosis at the stage of the EKG detects abnormal enlargement of the left ventricle, which in norm should not be.
Coarctation of the aorta, with slight narrowing of the isthmus lends itself well to treatment by resection with application of anastomoses.
If the aorta is narrowed on a large plot, then apply plastic surgery with the use of shunts, aortoplasty (for this purpose, the left subclavian artery.
Encouraging results also show balloon angioplasty and stent into the affected vessel.
Coarctation of the aorta - severe vascular and cardiovascular disease, so the predictions here may not be too rosy: it depends not only on the nature of the narrowing of the vessel, but also on the severity of complications.
However, the General rule is: the less narrowed aorta and the sooner undergone surgical treatment, the more hope that in the future the baby is safely outgrow their illness.
If the diagnosis shows a significant area exposed to the contraction in time the operation will enable such patients to survive only from thirty to thirty-five years: with age, they steadily develop symptoms of severe heart failure.
Possible death of patients from acceding infections resulting in bacterial endocarditis.
There are cases of sudden death from stroke or rupture of an aortic aneurysm.
Can I avoid the disease?
The mechanisms of the disease suggests that the narrowing of the aorta - pathology, which is laid at the stage of formation of the fruit. Play a role and genetic defects.
However, the defects of genes are not always due to some purely domestic reasons: it is proved that on the state of genetic apparatus the serious impact of harmful habits (Smoking parents, their tendency to frequent use of alcohol, drugs).
Its role in the deformation of the genes plays a unfavorable environment: air pollution, the intensity of his heavy metals and other industrial products can cause irreparable harm to the organisms parents, and the body of a child.
Hazardous working conditions (fuel, paints, other chemicals and machine-building enterprises) also destroy the genetic apparatus of man.
Thus, a healthy lifestyle, choosing an eco-friendly environment to live and work with normal working conditions be a good guarantee the birth of healthy childrenin the future.
So I advise to read about what is an aortic aneurysm the abdominal cavity.