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Suggest Treatment For Coarctation Of Aorta

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Posted on Thu, 2 Apr 2015
Question: My son 41 diagnosed with a kink in his aorta. He is scheduled for an echocardiogram tomorrow. what are his treatment options? He has COPD, hypertension, recently diagnosed with diabetes type 2. What does an echocardiogram entail. He is on Metformin, will this interfere with his tests?
doctor
Answered by Dr. Ilir Sharka (45 minutes later)
Brief Answer:
Aortic coarctation should be treated promptly.

Detailed Answer:
Hello!
XXXXXXX you for your question on HCM!

1. Regarding your concern it seems to imply an aortic coarctacion. That is a situation when because a narrowing of the proximal part of the aorta the patient suffers from hypertension in the upper part of the body and reduced blood flow to the lower part. Because of persistent hypertension in young adults they may suffer from cerebral artery aneurysms or even bleeding. Prompt and adequate anti-hypertensive therapy should be instituted immediately comprising negative inotropes (such as beta-blockers). Treatment options depend on the severity of coarctation:
(1) Surgical resection of the narrow segment is an optimal option in severe aortic coarctation.
(2) Angioplasty with balloon dilatation is another option in less severe narrowing.

2. By echocardiography, we can be measure pressure gradient across aortic narrowing, exact location and aortic coarctation, dilatation of adjacent portions, etc, as well as other potential congenital anomalies.
If a surgical strategy is planned then an aortic CT scan is performed to show detailed topography of coarctation.
The associated pathologies should be treated properly.

3. There are no implications of Metformin on cardiac ultrasound exam.

Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings from Dr. Iliri
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Ilir Sharka (30 hours later)
The echo showed:ef- 60% La - normal, LV--normal mild cocentric hypertrophy;no mass, thrombus or shunt; valves: non-coronary cusp - calcified; Pulm valve - trace regurgitation;
doctor
Answered by Dr. Ilir Sharka (9 hours later)
Brief Answer:
An entire aortic exam is necessary.

Detailed Answer:
Hello again!

Seems that cardiac ultrasound doesn't reflect any important associated anomaly. Mild concentric hypertrophy (not a finding to worry about) of the left ventricle is a reflection of hypertension imposed by aortic coarctation. It is important to evaluate the entire aorta comprising the level of narrowing and the proximal and distal parts of the aorta to rule out any associated narrowing or dilatation. Transesophageal echocardiography and aortic angio CT scan would help to clarify those issues.

As I told you before depending on the severity of aortic narrowing and associated findings will be defined the appropriate treatment strategy ( surgery or angioplasty). You have to talk with the attending doctor about that after exam results.

If you bring me detailed information about the severity of aortic coarctation and entire aorta status I would give a more concrete opinion to you.

Feel free to ask me whenever you need! My Best Wishes! Dr. Iliri
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9312 Questions

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Suggest Treatment For Coarctation Of Aorta

Brief Answer: Aortic coarctation should be treated promptly. Detailed Answer: Hello! XXXXXXX you for your question on HCM! 1. Regarding your concern it seems to imply an aortic coarctacion. That is a situation when because a narrowing of the proximal part of the aorta the patient suffers from hypertension in the upper part of the body and reduced blood flow to the lower part. Because of persistent hypertension in young adults they may suffer from cerebral artery aneurysms or even bleeding. Prompt and adequate anti-hypertensive therapy should be instituted immediately comprising negative inotropes (such as beta-blockers). Treatment options depend on the severity of coarctation: (1) Surgical resection of the narrow segment is an optimal option in severe aortic coarctation. (2) Angioplasty with balloon dilatation is another option in less severe narrowing. 2. By echocardiography, we can be measure pressure gradient across aortic narrowing, exact location and aortic coarctation, dilatation of adjacent portions, etc, as well as other potential congenital anomalies. If a surgical strategy is planned then an aortic CT scan is performed to show detailed topography of coarctation. The associated pathologies should be treated properly. 3. There are no implications of Metformin on cardiac ultrasound exam. Hope to have been helpful to you! Feel free to ask me whenever you need! Greetings from Dr. Iliri