Coarctation of the Aorta

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Questions and Answers

What is the primary purpose of surgical management in coarctation of the aorta?

  • To correct the narrowing of the aorta and restore normal blood flow. (correct)
  • To administer digitalis and diuretics for symptomatic relief of heart failure.
  • To alleviate shortness of breath and fatigue associated with poor feeding.
  • To manage secondary hypertension through the renin-angiotensin-aldosterone system.

Which assessment finding is most indicative of coarctation of the aorta in the upper extremities?

  • High blood pressure and bounding pulses. (correct)
  • Low blood pressure and absent pulses.
  • Cool temperature and decreased pulses.
  • Normal blood pressure and regular pulses.

What is the underlying cause of secondary hypertension in coarctation of the aorta?

  • Reduced blood flow to the upper extremities causing increased peripheral resistance.
  • Increased blood flow to the kidneys causing excessive sodium excretion.
  • Excessive blood flow to the lower extremities causing vasoconstriction.
  • Decreased blood flow to the kidneys activating the renin-angiotensin-aldosterone system. (correct)

Which of the following assessment findings is associated with decreased blood flow to the lower extremities in coarctation of the aorta?

<p>Cool extremities (D)</p> Signup and view all the answers

A patient with coarctation of the aorta is likely to exhibit which of the following blood pressure patterns?

<p>Higher in the upper extremities than in the lower extremities (D)</p> Signup and view all the answers

What is the significance of 'rib notching' as a diagnostic sign in coarctation of the aorta?

<p>It signifies erosion of the ribs due to enlarged intercostal arteries. (A)</p> Signup and view all the answers

In the context of coarctation of the aorta, what is the primary effect of narrowing of the aorta's lumen on blood flow?

<p>It obstructs blood flow, making it difficult for blood to pass through the narrowed section. (A)</p> Signup and view all the answers

Why might a patient with coarctation of the aorta experience shortness of breath, fatigue, and poor feeding?

<p>Due to the heart's inability to meet the body's demands. (B)</p> Signup and view all the answers

Which of the following complications is most directly associated with long-standing, uncorrected coarctation of the aorta?

<p>Cardiomegaly and heart failure (C)</p> Signup and view all the answers

The primary goal of medical management in a patient with coarctation of the aorta who is also experiencing heart failure is to do what?

<p>Improve cardiac function and reduce fluid overload. (A)</p> Signup and view all the answers

What is the expected effect of coarctation of the aorta on blood flow and pressure distribution?

<p>Increased blood flow and pressure in upper extremities; decreased in lower extremities. (A)</p> Signup and view all the answers

Why is prostaglandin E1 (PGE1) used in the medical management of coarctation of the aorta, particularly in neonates?

<p>To maintain patency of the ductus arteriosus. (C)</p> Signup and view all the answers

Which of the following best describes the auscultation findings typically associated with coarctation of the aorta?

<p>A soft or moderately loud systolic murmur prominent at the base of the heart. (B)</p> Signup and view all the answers

What is the primary reason for monitoring kidney function in patients with coarctation of the aorta?

<p>To assess the impact of reduced blood flow on renal function. (D)</p> Signup and view all the answers

What would be the immediate effect on blood pressure of surgically correcting a coarctation of the aorta?

<p>Decrease blood pressure in the upper extremities and increase in the lower extremities. (D)</p> Signup and view all the answers

Why is cyanosis sometimes observed in patients with coarctation of the aorta?

<p>Due to mixing of oxygenated and deoxygenated blood. (B)</p> Signup and view all the answers

Which surgical approach to coarctation of the aorta involves removing the narrowed segment and joining the two ends of the aorta together?

<p>Resection and end-to-end anastomosis (D)</p> Signup and view all the answers

How does balloon angioplasty work to treat coarctation of the aorta?

<p>By widening the narrowed section of the aorta using a balloon catheter. (B)</p> Signup and view all the answers

What is the purpose of diuretics like furosemide in the medical management of coarctation of the aorta?

<p>To reduce fluid overload. (B)</p> Signup and view all the answers

Flashcards

Cyanosis

Bluish discoloration of the skin due to poor circulation or inadequate oxygenation of the blood.

Upper extremities in Coarctation of Aorta

High blood pressure in the arms with bounding pulses.

Lower extremities in Coarctation of Aorta

Cool extremities, low blood pressure, diminished or absent femoral pulse.

Pathophysiology of Coarctation of Aorta

Difficulty in blood flow passing through the narrowed aortic lumen.

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Kidney effect in Coarctation

Less blood reaches the kidneys, activating the renin-angiotensin-aldosterone system, leading to secondary hypertension.

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Blood flow in Coarctation (Upper)

Blood flow increases into aortic branches, increasing blood flow and pressure in the upper extremities and head.

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Blood flow in Coarctation (Lower)

Blood flow and pressure decreases in the lower extremities.

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Cardiomegaly

Enlargement of the heart, specifically affecting the left side.

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Resection and end-to-end anastomosis

Involves cutting out the affected (narrowed) section of the aorta and directly sewing the two healthy ends back together.

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Subclavian aortoplasty

Surgical repair of the aorta, specifically the coarcted segment, using a graft from the subclavian artery.

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Balloon angioplasty

Procedure using a catheter with a balloon to widen the narrowed section of the aorta.

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Digitalis - Digoxin

Medication used to increase the force of heart contractions and control heart rate.

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Diuretics - Furosemide

Medication that helps the body remove excess fluid; reduces blood pressure.

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Prostaglandin E1 (PGE1)

A medication, prostaglandin E1, that helps keep the ductus arteriosus open.

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Study Notes

  • Coarctation of the Aorta

Assessment

  • Cyanosis is an assessment finding.
  • A soft or moderately loud systolic murmur prominent at the base of the heart is a finding.
  • High blood pressure in the arms with bounding pulses is noted in the upper extremities.
  • Cool lower extremities, low blood pressure, or a decreased or absent femoral pulse are noted.
  • Shortness of breath, fatigue, poor feeding, and poor growth and development can indicate failure to thrive.
  • Signs and symptoms of congestive heart failure may be present.
  • Rib notching can be seen on X-rays.
  • There are 3 signs seen via X-ray.

Pathophysiology

  • Narrowing of the lumen of the aorta occurs.
  • Blood has difficulty passing through the narrowed lumen.
  • Blood flow increases into aortic branches, increasing blood flow and pressure in the upper extremities and head.
  • The kidneys receive less blood, activating the renin-angiotensin-aldosterone system, leading to secondary hypertension.
  • Blood flow and pressure in the lower extremities decreases.

Surgical Management

  • Resection and end-to-end anastomosis are surgical options.
  • Subclavian aortoplasty and balloon angioplasty are surgical procedures.

Medical Management

  • Digitalis (Digoxin) can be used for management.
  • Diuretics like Furosemide may be used.
  • Prostaglandin E1 (PGE1) can be used.

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