Flashcards in Paeds: Coarctation of the aorta (adult type): Dr Clarke Deck (9)
Out flow obstruction
Not duct dependent becomes severe over the years
While the PDA is open the right ventricle can maintain cardiac output.
No murmur while PDA is open.
On closure HF and ESM
Post ductal symptoms
Baby breathless, grey and collapsed
Pulses are better n the arms than in the legs
BP lower in legs
No murmurs? ESM (check)
-Systemic HTN in arms esp right arm (lower in legs)
-ESM R sternal edge
-collaterals at the back -Radio-femoral delay (due to blood bypassing the obstruction via collaterals in the chest)
-rib notching (collateral intercostal arteries) -‘3’sign- notch in the descending aorta
Prostaglandin to keep PDA open while awaiting surgery.
Control HF prior to surgery