Diagnosis

The age at which coarctation of the aorta is diagnosed depends on the severity of the condition. If the aortic coarctation is severe, it's usually diagnosed during infancy. Coarctation of the aorta is occasionally diagnosed on sonogram of the fetus.

Adults and older children who are diagnosed with coarctation of the aorta may have milder cases and not have symptoms. They may often appear healthy until a doctor detects:

• High blood pressure in the arms
• A blood pressure difference between the arms and legs, with higher blood pressure in the arms and lower blood pressure in the legs
• A weak or delayed pulse in the legs
• A heart murmur — an abnormal whooshing sound caused by faster blood flow through the narrowed area

Tests

Tests to confirm a diagnosis of coarctation of the aorta may include:

• Echocardiogram. Echocardiograms use sound waves to create moving images of your heart that can be viewed on a video screen. This test can often show your doctor the location and severity of the aortic coarctation. It can also reveal other heart defects, such as a bicuspid aortic valve. Doctors often use echocardiograms to diagnose coarctation of the aorta and determine best treatment options for you.

• Electrocardiogram (ECG). An electrocardiogram records the electrical signals in your heart. During this test, sticky patches (electrodes) are attached to your chest and limbs. The patches have wires that connect to a monitor. They record the electrical signals that make your heart beat. A computer records the information and displays it as waves on a monitor or on paper.

  If the coarctation of the aorta is severe, the ECG may show thickening of the walls of the lower heart chambers (ventricular hypertrophy).

• Chest X-ray. A chest X-ray creates images of your heart and lungs. A chest X-ray might show a narrowing in the aorta at the site of the coarctation or an enlarged section of the aorta or both.
• Magnetic resonance imaging (MRI). An MRI uses a powerful magnetic field and radio waves to produce detailed images of your heart and blood vessels. This test can show the location and severity of the coarctation of the aorta, damage to other blood vessels, and any other heart defects. Your doctor may also use MRI results to guide treatment.
• Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create detailed cross-sectional images of your body.
• CT angiogram. A CT angiogram uses a dye and special X-rays to show the inside of your coronary arteries. It reveals blood flow in your veins and arteries. The test can show the location and severity of the coarctation of the aorta and determine whether it affects other blood vessels in your body. A CT angiogram can also be used to detect other heart defects or help guide treatment options.

• Cardiac catheterization. During this procedure, your doctor inserts a long, thin tube (catheter) into an artery or vein in your groin, arm or neck and threads it to your heart using X-ray imaging. Sometimes, dye is injected through the catheter to help your heart structures show up more clearly on the X-ray images.

  Cardiac catheterization can help determine the severity of the aortic coarctation. Your doctor may use it to help plan surgery or other treatment, if you need it. Catheter procedures may also be used to perform certain treatments for coarctation of the aorta.