COARCTATION OF THE AORTA IS IT POSSIBLE TO MAKE THE DIAGNOSIS AT AN EARLIER STAGE?
Background. Early diagnosis is an important prognostic factor for children with coarctation of the aorta. The objective of this study was to analyse the exact age and reason for referral in a group of children with the diagnosis.
Material and methods. The records of 49 patients with coarctation of the aorta diagnosed between 1987 and 2005 at Ullevål University hospital were reviewed.
Results. The median age at diagnosis was one month and the mean age 13 months, range 0-11,5 years. Eleven children were older than one year at the time of diagnosis. Thirty-nine children had a heart murmur. Thirty-five had weak or absent femoral pulses. Only 13 were diagnosed before leaving the maternity ward. Most of these had associated cardiac defects or malformations. All children presenting with symptoms of heart failure were diagnosed within eight weeks. Children diagnosed after eight weeks were mainly detected because of the incidental finding of a heart murmur.
Interpretation. Despite specific findings many children with coarctation of the aorta go undetected. The doctor should ask specifically about symptoms of heart failure during the six-week routine examination. Clinical examination implies auscultation on the back and assessment of the femoral pulses.