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#89477 12/14/02 03:42 PM
Joined: Jan 2001
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wwh Offline OP
Carpal Tunnel
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Dear wofahulicodoc: A spelling bee word was "coarct". Couldn't find it, so I looked for
"coarctation". To my surprise, medical meaning was not given"
1) coarctation. The American Heritage® Dictionary of the English Language: Fourth Edition.
2000.
...The state of being enclosed in an oval horny case. Used of an insect pupa

Now to look up "coarctation of the aorta".
Mirabile dictu, I found a radiograph, type not stated, showing narrowing where ascending
aorta becomes the descending aorta, just below the arrowhead. Used to be hopeless, now
can be surgically corrected. Marvelous.

http://info.med.yale.edu/intmed/cardio/chd/e_coarct/.


#89478 12/15/02 03:03 AM
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I don't have an X-ray to show you, but in flagrant cases the frontal film of the chest, with contrast material to opacify the aorta, will show a distinct shape like a numeral 3, the indentation is that sharp. It can occur anywhere in the upper aorta but is most common at the descending aorta, where the Ductus Arteriosus arises. The ductus sends blood around the lungs while the baby is in the uterus and getting its oxygen from the placenta instead, and it's supposed to shrink down within hours of birth - but on rare occasions the adjacent aorta constricts too, and the child is left with a coarctation.

Clinically, milder cases "just" have high blood pressure, because the pinched-off aorta doesn't permit blood to get to the kidneys at the proper pressure, and they react by trying to get the pressure up. When it's high enough to satisfy the kidneys beyond the constriction, it's generally too high in the head and arms in front of it.

Lesser degrees of coarction can present (we've discussed that word before! It means "be detectable" or "show up") as lower BP in the legs compared to the arms, or as a "heart murmur," although the sound is made not by the heart but by a high-velocity jet of blood squirting through the narrowed aorta.

The illustration you show is an Echocardiogram, and shows the internal structures of the heart and great vessels rather than just their shadow, as a chest X-ray would. Truly a marvel of technology, the echocardiogram, clever in conception and absolutely elegant in implementation. But that's another story. Which I don't have the technical expertise to do justice to, so I'll just express my admiration of the engineering involved...


#89479 12/15/02 03:22 AM
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wwh Offline OP
Carpal Tunnel
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Thanks, wofahulicodoc. I was hoping you would give more information than I could.



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