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

Trisha V Vigneswaran1,2, Manish D Sinha3, Israel Valverde1,2,4

  • 1Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's & St Thomas' Hospitals, London, SE1 7EH, UK.

Pediatric Cardiology
|October 19, 2017
PubMed

Insights

Children repaired for coarctation of the aorta (COA) often develop hypertension, increasing long-term cardiovascular risks. Early blood pressure monitoring and assessment are crucial for timely intervention in pediatric patients.

Area of Science:

  • Cardiology
  • Pediatric Cardiovascular Health

Background:

  • Coarctation of the aorta (COA) repair in childhood does not eliminate long-term cardiovascular risks.
  • Hypertension affects up to one-third of repaired COA patients, driving premature cardiovascular events.
  • Existing cardiovascular surveillance pathways are defined for adults, not children post-COA repair.

Purpose of the Study:

  • To review the prevalence and pathophysiology of hypertension in children after successful COA repair.
  • To discuss challenges in pediatric blood pressure assessment and central blood pressure measurement.
  • To highlight the need for enhanced cardiovascular surveillance strategies in pediatric COA patients.

Main Methods:

  • Literature review focusing on hypertension post-COA repair in children.
  • Discussion of blood pressure assessment challenges and non-invasive central blood pressure measures.
  • Exploration of complementary cardiovascular assessment techniques for pediatric patients.

Main Results:

  • Systolic arterial hypertension is a common complication in children post-COA repair.
  • Accurate blood pressure assessment in this cohort presents significant challenges.
  • Non-invasive central blood pressure monitoring offers potential for improved assessment.

Conclusions:

  • Pediatric patients with repaired COA require dedicated cardiovascular surveillance.
  • Timely identification and treatment of hypertension are essential to mitigate long-term risks.
  • Further research into pediatric-specific assessment techniques is warranted.

Keywords:
Arterial stiffnessCentral blood pressureCoarctation of the aortaHypertensionPaediatricVasculopathy

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