Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about co-arctation of the aorta. And if you want to follow along with written notes on

this topic, you can follow along at zero tofinals.com slash co-arctation or in the cardiology section of the zero-definals

pediatrics book. So let's get straight into it. Co-actation of the aorta is a congenital

condition where there's narrowing of the aortic arch and this narrowing usually occurs around

the ductus arteriosis.

The severity of the coactation or the severity of the narrowing can vary from mild to severe.

It's often associated with an underlying genetic condition, particularly Turner's syndrome.

Narrowing of the aorta reduces the pressure of blood flowing to the arteries that are distal to the narrowing.

It increases the pressure in the areas that are proximal to the narrowing.

Basically the branches of the aorta that occur after the narrowing will have a lower pressure

and the branches of the aorta that occur before the narrowing will have a lower pressure, and the branches of the aorta that occur before

the narrowing will have a higher pressure. This means there's a higher pressure inside the heart,

and usually also the first three branches of the aorta. So how does it present? Often the only

indication of co-actation of the aorta in a neonate may be weak femoral pulses.

Performing a four limb blood pressure will reveal high blood pressure in the limbs that are supplied from arteries that come before the narrowing,

and a lower blood pressure in the limbs that come after the narrowing.

There may be a systolic murmur which is heard below the left clavicle, which is called the left

infraclavicular area, and also below the left scapular. Co-actation may have some other signs in infancy,

and these can be tachychnya or fast respiratory rate and an increased work of breathing, poor feeding,

and a grey floppy baby. Additional signs that may develop over time are a left ventricular

heave and this is due to left ventricular hypertrophy due to the increased strain on the left side

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