Etiology
Coarctation of the aorta presents as a narrowing of the aorta near the heart. Specifically, near where the ductus arteriosus joins the heart. Because this narrowing occurs distal to the vessels that supply blood to the head and upper extremities, those locations receive higher blood pressure. The areas that are supplied with blood from the aorta distal to this area receive less blood and have lower blood pressure. These areas include the abdomen and lower extremities. It is thought a variety of factors including environment and genetics converge in utero and cause this defect. (Hockenberry & Wilson, 2015)
Pathophysiology
The result of this congenital defect is increased arterial pressure proximal to the obstruction at the vessels that supply the head, neck, and upper extremities, and lower arterial pressure distal to the obstruction to the abdominal aorta and its branches. Coarctation of the aorta makes up 5–9% of all congenital conditions of the heart. ( Kaya, Deniz, Paydas, & Aksun, 2012)
Clinical manifestations Coarctation of the aorta presents as high blood pressure in …show more content…
Digoxin may be used in cases of heart failure, so the nurse will need to monitor for signs of digoxin toxicity, including vomiting, diarrhea, dysrhythmias, decreased urine output, and reduced level of consciousness. After surgical repair of the defect, the nurse will need to assess for hypertension and administer medications such as nitroprusside, esmolol, or milrinone, and ACE inhibitors or beta-blockers to reduce the workload of the heart.