Hypertension in Coarctation of the Aorta: Challenges in Diagnosis in Children

TY - JOUR

T1 - Hypertension in Coarctation of the Aorta

T2 - Challenges in Diagnosis in Children

AU - Vigneswaran, Trisha V.

AU - Sinha, Manish D.

AU - Valverde, Israel

AU - Simpson, John M.

AU - Charakida, Marietta

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Evidence indicates that patients with coarctation of the aorta (COA) suffer from increased cardiovascular morbidity and mortality in later life despite successful repair of COA in childhood. Systolic arterial hypertension is common, presenting in up to one-third of patients, and is regarded as the main driver of premature cardiovascular events in this group of patients. In this review, we discuss the prevalence and pathophysiology of hypertension in children following successful COA repair with no residual arch obstruction. The challenges in accurate blood pressure assessment at this early phase are considered and non-invasive measures of central blood pressure are discussed. Although the pathways for investigations in adults are well defined, we highlight the need to address the issues of cardiovascular surveillance in children and describe techniques which can provide complementary information for cardiovascular assessment in this group of patients such that timely treatment can occur.

AB - Evidence indicates that patients with coarctation of the aorta (COA) suffer from increased cardiovascular morbidity and mortality in later life despite successful repair of COA in childhood. Systolic arterial hypertension is common, presenting in up to one-third of patients, and is regarded as the main driver of premature cardiovascular events in this group of patients. In this review, we discuss the prevalence and pathophysiology of hypertension in children following successful COA repair with no residual arch obstruction. The challenges in accurate blood pressure assessment at this early phase are considered and non-invasive measures of central blood pressure are discussed. Although the pathways for investigations in adults are well defined, we highlight the need to address the issues of cardiovascular surveillance in children and describe techniques which can provide complementary information for cardiovascular assessment in this group of patients such that timely treatment can occur.

KW - Arterial stiffness

KW - Central blood pressure

KW - Coarctation of the aorta

KW - Hypertension

KW - Paediatric

KW - Vasculopathy

UR - http://www.scopus.com/inward/record.url?scp=85031505251&partnerID=8YFLogxK

U2 - 10.1007/s00246-017-1739-x

DO - 10.1007/s00246-017-1739-x

M3 - Review article

AN - SCOPUS:85031505251

SN - 0172-0643

VL - 39

JO - Pediatric Cardiology

JF - Pediatric Cardiology

IS - 1

ER -