Paediatrics: Coarctation of the Aorta: Free MSRA Podcast

🫀 FREE MSRA PODCAST – Coarctation of the Aorta (CoA): Spotting the Narrowing, Saving LivesThis deep dive takes you through all the essentials of Coarctation of the Aorta (CoA) for the MSRA – from definition and classic associations to clinical signs, diagnosis, management, and complications. Tune in for practical, exam-focused tips and memory aids.🧠 Key Learning Points📌 Definition• Coarctation of the aorta (CoA) is a congenital narrowing of the aorta – most commonly just after the left subclavian artery branches off• Creates a “bottleneck” for blood leaving the heart• Causes high pressure before the narrowing (arms, head) and low pressure after (legs)📌 Causes & Risk Factors• Congenital: Abnormal development of the aorta during fetal life• Genetics: – Strong association with Turner syndrome – Linked with other congenital heart defects: bicuspid aortic valve (seen in up to 70%), VSD• Family history of congenital heart defects• Maternal factors (e.g., infections like rubella during pregnancy)📌 Clinical Features• Neonates: – May present critically ill as the ductus arteriosus closes – Poor feeding, lethargy, tachypnoea, shock – Classic findings:  - Weak/absent femoral pulses  - Radiofemoral delay  - Upper limb hypertension, lower limb hypotension  - Differential cyanosis (pink upper body, blue lower body)  - Systolic murmur (back/scapular or left infraclavicular area)• Older children/adults: – May be asymptomatic – Found incidentally (hypertension, murmur) – Headaches, epistaxis, leg claudication, cold feet, muscle weakness📌 Memory Aid:Think: “Check the pulses, check the pressure!” – High BP in arms, low/weak in legs = suspect CoA📌 Diagnosis• Echocardiography – first-line for visualising the narrowing, measuring gradient, and checking associated defects• MRI/CT angiography – detailed anatomy, pre-op planning• CXR: “Figure 3” sign, rib notching (from collaterals)• ECG: LVH in older children/adults• Bloods: To check for other hypertension causes📌 Management• Critically ill neonates: – Prostaglandin E1 (keep ductus arteriosus open) – Surgery/balloon angioplasty (definitive)• Older children/adults: – Balloon angioplasty + stent or surgical repair – Antihypertensive medications before and after repair• Lifelong follow-up: Risk of re-coarctation, hypertension, aneurysm📌 Complications• Untreated: – Heart failure, aortic rupture/dissection, stroke, endocarditis, premature coronary disease, subarachnoid haemorrhage• Post-repair: – Re-coarctation, aneurysm formation, persistent hypertension📌 Prognosis• Excellent with early repair• Untreated: <20% survive beyond age 50• Lifelong cardiac follow-up is essential📎 More MSRA Resources for Coarctation of the Aorta:📝 Revision Notes: https://www.passthemsra.com/topic/coarctation-of-the-aorta-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/coarctation-of-the-aorta-flashcards/💬 Accordion Q&A: https://www.passthemsra.com/topic/coarctation-of-the-aorta-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/coarctation-of-the-aorta-rapid-quiz/🎓 Paediatrics Course: https://www.passthemsra.com/courses/paediatrics-for-the-msra/#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQandANotes #MSRAAccordions #Paediatrics #CoarctationOfTheAorta #Cardiology #PaediatricCardiology