Adult-type Coarctation of the Aorta (CoA)

Coarctation of the aorta is a narrowing of the aorta.

Clinical presentation

Symptoms	Asymptomatic
Physical signs	Systemic hypertension Ejection systolic murmur at upper sternal edge Collaterals heard with continuous murmur at the back Radio-femoral delay. This is due to blood bypassing the obstruction via collateral vessels in the chest wall and hence the pulse in the legs is delayed

Investigations

Chest radiograph	Rib-notching due to the development of large collateral intercostal arteries running under the ribs posteriorly to bypass the obstruction
ECG	Left ventricular hypertrophy

Management

The approach to native coarctation varies across centers. Most centers recommend surgical correction of a native coarctation. Others perform balloon angioplasty with or without placement of a stent to relieve coarctation in the adult.