Aortic coarctation pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Pathophysiology
Coarctation of the aorta can be either congenital or acquired.
Congenital coarctation results from an infolding of the aortic media that incorportaes ductal tissue, forming a ridge that eccentrically narrows the lumen of the vessel. Subsequent intimal proliferation on the ridge leads to progressive narrowing of the vessel lumen. There is a dilatation before and after the narrowing, giving the aorta an hourglass appearance. The exact etiology of the aortic abnormality remains unclear but likely involves a defect in the vascular wall of the aorta due to reduced antegrade intrauterine blood flow or to constriction of ductal tissue extending into the thoracic aorta.
Acquired coartation can occur in systemic arteritides such as Takayasu arteritis. Additionally it may occur in rare cases of severe atherosclerosis.