COARCTION OF THE AORTA*

Abstract

INTRODUCTION:

Systemic Hypertension in the majority of cases affects the arterial tree in all the four extremities more or less uniformly; with pressure in the lower extremities higher than the upper extremities. However there are conditions leading to systemic arterial hypertension with differential involvement of the systemic arteries. The purpose of this study is to document the clinical presentation, physical findings, haemodynamic angiographic data and surgical results in these patients.

METHODS AND MATERIALS:

All patients referred to the authors with the diagnosis of systemic hypertension since May 1975 were included in the study. Twenty three cases were discovered to have delayed. Right Heart Cath. was done in 6 patients. Aortic root injection of 76% urogaphin was made and filming by 33 mm cine-camera was done in the L.A.O. view, Another injection was given just above the coarctation in AP view. Pressures were recorded on Multi— channel physiological or E for M VR-12 recorder with the transducer at the mid chest level. All patients were presented for surgery. The results were as detailed in Tables I to V.

DISCUSSION:

Coarctation of the aorta forms somewhere between 44% of patients with Congenital Heart Disease (1,2,3,) It is also mentioned that it forms less than 0.5% of the hypertensive population (4). In summary, our findings show that all PatieIt5 having hypertension below the age of 40 years should also have examination of the femoral pulses and B.P. checked in the lower extremities to detect coarctation of the aorta. Because of the associated Aortic and Mitral valve disease and more so the high frequency of abdominal coarctation in our population, all suspected patients should be studied carefully. These patients need continued medical supervision and if need be treatment following surgery.