{{Infobox_Disease |
  Name           = Aortic coarctation |
  Image          = |
  Caption        = |
  DiseasesDB     = 2876 |
  ICD10          =  |
  ICD9           =  |
  ICDO           = |
  OMIM           = 120000 |
  MedlinePlus    = |
  eMedicineSubj  = med |
  eMedicineTopic = 154 |
  MeshID         = D001017 |
}}
[[Image:Coarctation.png|thumb|right|Sketch showing heart with coarctation of the aorta. A: Coarctation (narrowing) of the aorta. 1:inferior caval vein, 2:right pulmonary veins, 3: right pulmonary artery, 4:superior caval vein, 5:left pulmonary artery, 6:left pulmonary veins, 7:right ventricle, 8:left ventricle, 9:pulmonary artery, 10:Aorta
]]
thumb|right|Schematic drawing of alternative locations of a coarctation of the aorta, relative to the ductus arteriosus. A: ductal coarctation, B: preductal coarctation, C: postductal coarctation. 1: Aorta ascendens, 2: Arteria pulmonalis, 3: Ductus arteriosus, 4: Aorta descendens, 5: Trunchus brachiocephalicus, 6:  Arteria carotis communis sinister, 7: Arteria subclavia sinister

'''Aortic coarctation''' is narrowing of the aorta in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts.

==Types==
There are three types:<ref>Valdes-Cruz LM, Cayre RO: ''Echocardiographic diagnosis of congenital heart disease.'' Philadelphia, 1998.</ref>
# Preductal coarctation: The narrowing is proximal to the ductus arteriosus. If severe, blood flow to the aorta distal to the narrowing (supplying lower body) is dependent on a patent ductus arteriosus, and hence its closure can be life-threatening. Preductal coarctation results when an intracardiac anomaly during fetal life decreases blood flow through the left side of the heart, leading to hypoplastic development of the aorta.  This is the type often seen in infants with Turner's Syndrome.<ref name="Robbins"></ref>
# Ductal coarctation: The narrowing occurs at the insertion of the ductus arteriosus. This kind usually appears when the ductus arteriosus closes.
# Postductal coarctation: The narrowing is distal to the insertion of the ductus arteriosus. Even with an open ductus arteriosus blood flow to the lower body can be impaired. Newborns with this  type of coarctation may be critically sick from the birth. This type is most common in adults. It is associated with notching of the ribs, hypertension in the upper extremities, and weak pulses in the lower extremities. Postductal coarctation is most likely the result of muscular ductal (ductus arteriosis) extends into the aorta during fetal life.

==Signs and symptoms==
Arterial hypertension in the right arm with normal to low blood pressure in the lower extremities is classic. Poor peripheral pulses in the femoral arteries may be found in severe cases.

If the coarctation is situated before the left subclavian artery, asynchronous radial pulses will be detected in the right and left arms. A radial-femoral delay between the right arm and the femoral artery would be apparent, whilst no such delay would occur under left arm radial-femoral palpation. 

A coarctation occurring after the left subclavian artery will produce synchronous radial pulses, but radial-femoral delay will be present under palpation in either arm. 

==Imaging and diagnosis==
With imaging, resorption of the lower part of the ribs may be seen, due to increased blood flow over the aortic wall at the site of cervical rib obstruction, with consequent post-stenotic dilation. This physiology results in the reversed '3' image for which the sign is named.<ref name="medstudy"></ref><ref></ref><ref></ref>

Coarctation of the aorta can be accurately diagnosed with magnetic resonance angiography. In teenagers and adults echocardiograms may not be conclusive. In adults with untreated coarctation blood often reaches the lower body through collaterals, eg. internal thoracic arteries via. the subclavian arteries. Those can be seen on MR or angiography. An untreated coarctation may also result in hypertrophy of the left ventricle.

La '''coartazione dell'aorta''' è una malformazione congenita dell'aorta. 

==Descrizione ==

La coartazione dell’aorta consiste in un restringimento dell’aorta di solito nel tratto ascendente o talvolta in quello discendente. Nelle arterie che si dipartono dal tratto precedente al punto di restringimento le pressioni saranno normali. Il bambino avrà però delle pressioni diverse a livello degli arti inferiori rispetto a quelli superiori. Il sangue che riesce ad andare giù perfonderà maggiormente le altre arterie e consentirà lo sviluppo di due circoli collaterali:
•	anteriore dato dalla mammaria interna e dalle iliache esterne che si anastomizzano
•	posteriore dato dalle arterie aorta discendente e ileo… 

l’arteria toracica interna che nasce dalla succlavia risulta aumentata di volume e potrà creare dei solchi a livello costale visibili all’RX.
Anche questa patologia porterà scompenso e il paziente mostrerà segni di stanchezza, non riuscirà a camminare perché le gambe non saranno ben perfuse, ecc. In realtà ci sono vari tipi di coartazione (prima o dopo il dotto arterioso) quindi diversi tipi di intervento chirurgico: generalmente si realizza per via per cutanea mediante un palloncino che permette di dilatare il punto coartato. In cosa consiste la dotto dipendenza? In questi casi, grazie al dotto di Botallo, il sangue riesce a raggiungere l’aorta. I pazienti infatti inizialmente vengono trattati con prostaglandine (PGE2) che prodotte normalmente dalla placenta permettono di mantenere pervio il dotto permettendo al sangue di raggiungere la circolazione sistemica.

===Coartazione aortica preistmica con dotto di Botallo non obliterato ===

===Coartazione aortica con dotto di Botallo obliterato ===

===Coartazione aortica postistmica con dotto di Botallo non obliterato ===