Hypertension Associated with Coarctation of the Aorta Revisited: Case-Based Update from Experience of Three Children

Coarctation of the aorta (CoA) can present with different clinical pictures depending on the severity of the narrowness in the coarcted aortic segment in an age range between newborn and adolescence. Sometimes, it can cause intracranial hemorrhage or infarction when diagnosis and treatment are delayed. The aim of this report is taking attention to CoA as a cause of systemic hypertension and is also emphasizing the differences of diagnostic approach for hypertension in children from adults. Two cases of hypertensive cerebral hemorrhage and one case of hypertensive cerebellar infarction associated with CoA are reported. These cases help us to pay attention to the possibility of CoA in adolescents with hypertensive stroke. We want to emphasize the importance of physical examination for evaluation of hypertension and to impress the diagnostic approach for secondary hypertension in children.

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Long-term systemic hypertension in children after successful repair of coarctation of the aorta

American Heart Journal ◽

10.1016/0002-8703(88)90020-8 ◽

1988 ◽

Vol 115 (6) ◽

pp. 1268-1273 ◽

Cited By ~ 34

Author(s):

Rosa Simsolo ◽

Beatriz Grunfeld ◽

Maria Gimenez ◽

Marta Lopez ◽

Gustavo Berri ◽

...

Keyword(s):

Coarctation Of The Aorta ◽

Systemic Hypertension ◽

Hypertension In Children ◽

Successful Repair

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Cerebellar Infarction and Coarctation of the Aorta - causal relation or coincidence?

Neuropediatrics ◽

10.1055/s-0032-1307115 ◽

2012 ◽

Vol 43 (02) ◽

Author(s):

A Bertsche ◽

S Syrbe ◽

M Bernhard ◽

C Schober ◽

W Siekmeyer ◽

...

Keyword(s):

Causal Relation ◽

Coarctation Of The Aorta ◽

Cerebellar Infarction

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Secondary Hypertension in Children and Adolescents: Novel Insights

Current Hypertension Reviews ◽

10.2174/1573402115666190416152820 ◽

2020 ◽

Vol 16 (1) ◽

pp. 37-44 ◽

Cited By ~ 1

Author(s):

Katerina Chrysaidou ◽

Athanasia Chainoglou ◽

Vasiliki Karava ◽

John Dotis ◽

Nikoleta Printza ◽

...

Keyword(s):

Blood Pressure ◽

Children And Adolescents ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Blood Pressure Monitoring ◽

Secondary Hypertension ◽

Pressure Monitoring ◽

Cardiovascular Morbidity And Mortality ◽

Rising Incidence ◽

Hypertension In Children

Hypertension is a significant risk factor for cardiovascular morbidity and mortality, not only in adults, but in youths also, as it is associated with long-term negative health effects. The predominant type of hypertension in children is the secondary hypertension, with the chronic kidney disease being the most common cause, however, nowadays, there is a rising incidence of primary hypertension due to the rising incidence of obesity in children. Although office blood pressure has guided patient management for many years, ambulatory blood pressure monitoring provides useful information, facilitates the diagnosis and management of hypertension in children and adolescents, by monitoring treatment and evaluation for secondary causes or specific phenotypes of hypertension. In the field of secondary hypertension, there are numerous studies, which have reported a strong association between different determinants of 24-hour blood pressure profile and the underlying cause. In addition, in children with secondary hypertension, ambulatory blood pressure monitoring parameters offer the unique advantage to identify pediatric low- and high-risk children for target organ damage. Novel insights in the pathogenesis of hypertension, including the role of perinatal factors or new cardiovascular biomarkers, such as fibroblast growth factor 23, need to be further evaluated in the near future.

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Landmark lecture: Perloff lecture: Tribute to Professor Joseph Kayle Perloff and lessons learned from him: aortopathy in adults with CHD

Cardiology in the Young ◽

10.1017/s1047951117002116 ◽

2017 ◽

Vol 27 (10) ◽

pp. 1959-1965 ◽

Cited By ~ 2

Author(s):

Koichiro Niwa

Keyword(s):

Aortic Valve ◽

Aortic Root ◽

Coarctation Of The Aorta ◽

Left Ventricular ◽

Lessons Learned ◽

Aortic Dilatation ◽

Persistent Truncus Arteriosus ◽

Artery Flow ◽

Age Range ◽

Left Heart Syndrome

AbstractMarfan syndrome, bicuspid aortic valve, and/or coarctation of the aorta are associated with medial abnormalities of the ascending aortic or para-coarctation aorta. Medial abnormalities in the ascending aorta are prevalent in other type of patients with a variety of CHDs such as single ventricle, persistent truncus arteriosus, transposition of the great arteries, hypoplastic left heart syndrome, and tetralogy of Fallot, encompassing a wide age range and may predispose to dilatation, aneurysm, and rapture necessitating aortic valve and root surgery. These CHDs exhibit ongoing dilatation of the aortic root and reduced aortic elasticity and increased aortic stiffness that may relate to intrinsic properties of the aortic root. These aortic dilatation and increased stiffness can induce aortic aneurysm, rapture of the aorta, and aortic regurgitation, but also provoke left ventricular hypertrophy, reduced coronary artery flow, and left ventricular failure. Therefore, a new clinical entity can be used to call this association of aortic pathophysiological abnormality, aortic dilation, and aorto-left ventricular interaction – “aortopathy”.

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