Tests and diagnosisBy Mayo Clinic staff
The age at which people with coarctation of the aorta are diagnosed depends on the severity of the condition. If the aortic coarctation is severe, it's usually diagnosed during infancy. Testing for coarctation of the aorta while your baby is still in the womb is often not possible.
Adults and older children tend to have milder cases and usually appear healthy until a doctor detects:
- High blood pressure in the arms
- A blood pressure difference between arms and legs
- A weak or delayed pulse in the legs
- A heart murmur — an abnormal whooshing sound caused by turbulent blood flow
Tests to confirm a diagnosis of coarctation of the aorta include:
- Chest X-ray. X-rays produce pictures by passing an X-ray beam through your body. A chest X-ray may show an enlarged heart or a narrowing in the aorta at the site of the coarctation.
- Echocardiogram. Echocardiograms use high-pitched sound waves to produce an image of your heart. Sound waves bounce off your heart and produce moving images that can be viewed on a video screen. An echocardiogram may detect the location and severity of the aortic coarctation and can show other heart defects, such as a bicuspid aortic valve.
- Electrocardiogram (ECG). An ECG test records the electrical activity in your heart each time it contracts. For this procedure, patches with wires (electrodes) are placed on your chest, wrists and ankles. The electrodes measure electrical activity, which is recorded on paper or a computer monitor. If the coarctation of the aorta is severe, the ECG will show that you might have a thickened heart muscle (ventricular hypertrophy).
- Magnetic resonance imaging (MRI). An MRI scan is a test that uses a magnetic field and pulses of radio wave energy to make pictures of your body. An MRI of your chest will reveal the location of the coarctation of the aorta and determine whether it affects other blood vessels in your body.
- Computerized tomography (CT) angiogram. A CT angiogram allows your doctor to check your arteries to see if your aorta is narrowed. In this minimally invasive test, you'll change into a hospital gown and lie on a table that's part of the CT scanning machine. You'll receive an injection of a radioactive dye, and the doughnut-shaped CT scanner will be moved to take images of the arteries in your heart. The images are then sent to a computer screen for your doctor to view.
- Cardiac catheterization. During this procedure, your doctor inserts a thin flexible tube (catheter) into an artery or vein in your groin and threads it up to your heart. A dye is injected through the catheter to make your heart structures visible on X-ray pictures. Cardiac catheterization helps determine the severity of the aortic coarctation.
- Coarctation of the aorta. American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Coarctation-of-the-Aorta-CoA_UCM_307022_Article.jsp. Accessed Feb. 7, 2012.
- Keane JF, et al, eds. Nadas' Pediatric Cardiology. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-1-4160-2390-6..50001-5&isbn=978-1-4160-2390-6&uniqId=322245209-3. Accessed March 9, 2012.
- Agarwala BN, et al. Clinical manifestations and diagnosis of coarctation of the aorta. http://www.uptodate.com/index. Accessed Feb. 7, 2012.
- Agarwala BN, et al. Management of coarctation of the aorta. http://www.uptodate.com/index. Accessed Feb. 7, 2012.
- Wilson W, et al. Prevention of infective endocarditis: Guidelines from the American Heart Association. Circulation. 2007;116:1736.
- Kenny D, et al. Coarctation of the aorta: From fetal life to adulthood. Cardiology Journal. 2011;18:487.