Coarctation of the aorta: a misdiagnosed cause of hypertension

J. B. Oliveira, C. Germano, J. Roda, T. Quinaglia
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Abstract

Clinically, patients may remain asymptomatic for years, although up to half may present lack of lower limbs pulse, typical systolic-diastolic murmur and an increased pressure gradient by echocardiography, which is required for the diagnosis. This method allows measuring the aortic gradient, but eventually a computed tomography angiography (CTA) of the aorta may be also necessary. Treatment involves clinical management of hypertension and heart failure symptoms, followed by surgical or balloon angioplasty for the correction of the narrowed segment. Though the surgical correction is often successful, life-long clinical and echocardiographic follow-up is required as re-coarctation occurs in one-third of patients.
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主动脉缩窄:高血压的一个误诊原因
临床上,患者可能多年无症状,尽管多达一半的患者可能表现为下肢脉搏缺失,典型的收缩期-舒张期杂音和超声心动图压力梯度升高,这是诊断所必需的。这种方法可以测量主动脉梯度,但最终可能还需要主动脉的计算机断层血管造影(CTA)。治疗包括高血压和心力衰竭症状的临床管理,随后进行手术或球囊血管成形术来矫正狭窄的节段。虽然手术矫正通常是成功的,但由于三分之一的患者再次发生缩窄,需要终身临床和超声心动图随访。
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