Coarctation of the Aorta, Known Yet Can Be Missed

The clinical presentation of coarctation of aorta (CoA) is well known; however, it is the most common congenital heart disease in the newborn period to be missed, with significant mortality and morbidity associated with missing the diagnosis. We report a 20-day-old newborn boy who presented with con...

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Bibliographic Details
Main Authors: Asim Al Balushi, Sunny Zacharias, Khalfan Al Senaidi
Format: Article
Language:English
Published: Oman Medical Specialty Board 2013-05-01
Series:Oman Medical Journal
Subjects:
Online Access:http://www.omjournal.org/fultext_PDF.aspx?DetailsID=380&type=fultext
Description
Summary:The clinical presentation of coarctation of aorta (CoA) is well known; however, it is the most common congenital heart disease in the newborn period to be missed, with significant mortality and morbidity associated with missing the diagnosis. We report a 20-day-old newborn boy who presented with congestive heart failure and weak femoral pulses. Chest X-ray (CXR) showed cardiomegaly and pulmonary edema and electrocardiography (ECG) showed extreme right axis deviation and absent left ventricular forces in the left precordial leads. Based on these, clinical suspicion of coarctation of aorta was made and confirmed by echocardiography. After initial stabilization with prostaglandin E2 infusion, child underwent urgent coarctation of aorta repair with uneventful post-operative course. High index of suspicion for coarctation of aorta in a newborn with such presentation is required and urgent referral to Pediatric Cardiology and cardiac surgery center is mandatory to reduce the morbidity and mortality associated with missing the diagnosis.
ISSN:1999-768X
2070-5204