coarctation of aorta

ELI5: When someone loses a hand/arm etc., and the wound is cauterised, what happens to the blood flow? Wouldn't the arteries leading to the wound clog up with blood, leading to extremely high blood pressure and a heart attack?

Our circulatory system is a lot like a big road system. Now imagine you’re taking a trip in a car. Along the way there’s a wreck that no one can pass. It slows cars down and there’s traffic buildup so you take a detour. You exit off the highway and try to find a different way to go. In very simple terms this is how circulation works in the body. Red blood cells behave a lot like people in cars - they hate traffic, and they always want to take the least congested route. In the body, what path these cells take is determined mostly by pressure, traveling from areas of highest pressure (left ventricle) all the way back to areas of lowest pressure (the right atrium). So what happens when there’s a kink in the system? To answer your question about cauterization, this is like a whole road being closed. Red blood cells build up behind the blockage, increasing crowding, which increases the pressure. Blood cells coming into the jam are more likely to be detoured into another vessel branch that has less pressure. Now our circulatory system is incredibly connected by branches that we call “collaterals.” This connectivity prevents the problem of “extremely high pressures” that you’re talking about because there are literally millions of release valves that keep the pressure manageable. They’re essentially branches in parallel, if you know something about circuits.

The amazing thing about collateral circulation is that if there is still high pressure, the body will make completely new vessels to reduce the pressure over time. It will even remodel existing blood vessels to handle more blood than they could originally. A great example of this is the rib notching phenomenon in patients with coarctation of the aorta. This is a disease where the aorta has a spot that looks like someone tied a rubber band around it. So instead of passing through this tight squeeze, blood takes a detour through vessels that go around your ribs. The vessels get bulkier from all the new blood they have to carry, eventually causing them to create “notches” in the rib where the vessel bulges against it.

There are some cases where the catastrophe you described can happen though, and this typically only occurs where there are no alternative branches for blood to escape. The best example I can think of is a saddle embolus, often happening from a clot in your leg veins that breaks off and travels all the way to your heart. Some background, there is only one route to get from the heart to the lungs - the single pulmonary trunk that branches off into the right and left pulmonary arteries. If a clot is large enough to get caught at this branch point it will “saddle” both arteries, cutting off blood supply to the lungs and left heart which kills you almost instantly.

So the main idea here is that collateral circulation is the key to keeping your blood flowing when there is a blockage. I mentioned two examples that show the role collaterals play. In coarctation of the aorta, the body may divert blood through pre-existing collaterals as an emergency pressure release, and remodel/make new ones as a long term fix. But in a saddle embolus there are no collaterals and there is no time to make new ones. The pressures build up to dangerous levels on the right side of the heart and fall to near zero on the left side. Eventually the heart stops pumping altogether and you die.

Explain Like I`m Five: good questions, best answers.

List of Cardiac Defects and Their Associated Repairs

Please note: This is by no means a comprehensive list. There are other surgical procedures so please don’t treat this post like the Bible of cardiac defect repairs. Every child is different, every anatomy is different, and many patients will require nontraditional repairs. I did not mention certain procedures (such as the hemi-Fontan or Sano modification, etc) because that’s just too much information. One day I may make a surgical repair post for each defect (and at that time would detail modified, Hybrid, non-traditional approaches, etc), but until then: keep in mind that these are not the ONLY options.

Atrial Septal Defect/Ventral Septal Defect - Self-resolving, simple suture or patch repair.

Coarctation of the Aorta - End-to-end anastomosis, subclavian flap angioplasty

Double Inlet Left Ventricle - Damus-Kaye-Stansel procedure, single ventricle palliation

Double Outlet Right Ventricle - Rastelli procedure, RV to PA conduit

Ebstein’s Anomaly of the Tricuspid Valve - Blalock-Taussing shunt, Carpentier’s procedure, Tricuspid valve repair, Starnes procedure

Hypoplastic Left Heart Syndrome - Norwood procedure, Bidirectional Glenn procedure, Fontan procedure

Pulmonary Atresia with Intact Ventricular Septum - Balloon atrial septostomy, pulmonary valvotomy, PDA stent

Pulmonary Atresia with Ventricular Septal Defect - RV to PA conduit and VSD repair

Transposition of the Great Arteries - Arterial switch operation

Let me educate you on my heart problem and WHY I cannot become over-stressed. People think that when I have panic attacks or when I have chest pains it’s because I want attention. 

Uh uh. 

Let me tell you a thing or two about the Coarctation of the Aorta:


There are 3 types: 

  1. Preductal coarctation: The narrowing is proximal to the ductus arteriosus. Blood flow to the aorta that is distal to the narrowing is dependent on the ductus arteriosus; therefore severe coarctation 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.
  2. Ductal coarctation: The narrowing occurs at the insertion of the ductus arteriosus. This kind usually appears when the ductus arteriosus closes
  3. 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. 

Signs and Symptoms

In mild cases, children may show no signs or symptoms at first and their condition may not be diagnosed until later in life. Some children born with coarctation of the aorta have other heart defects, too, such as aortic stenosis, ventricular septal defect, patent ductus arteriosus or mitral valve abnormalities.

Coarctation is about twice as common in boys as it is in girls. It is common in girls who have Turner syndrome.

Symptoms may be absent with mild narrowings (coarctation). When present, they include: difficulty breathing, poor appetite or trouble feeding, failure to thrive. Later on, children may develop symptoms related to problems with blood flow and an enlarged heart. They may experience dizziness or shortness of breath, faint or near-fainting episodes, chest pain, abnormal tiredness or fatigue, headaches, or nosebleeds. They may have cold legs and feet or have pain in their legs with exercise 

Treatment? Haha

You can either A: Have therapy or B: Have surgery. Guess who had both my friends? This shit sucks. And what’s worse is I developed a murmur afterwards that has followed me into adulthood. They’re painful and they suck and sometimes your heart stutters and knocks the fucking air out of you. Haha. I hate it.

What they did for me was took a piece of rubber and then cut out the bad part of my aorta and then placed that shit right around that opening and BAM. Aorta fixed. 

But problems fixed? No. I still get chest pains and nosebleeds and I have to watch my blood pressure or else I faint. I cannot get stressed out or else it causes me SEVERE pains and my heart stutters. 

This shit fucking SUCKS.

Not to mention this long ass scar is ever present on my back: 

External image

NOW! 

My brother and I BOTH had it. Making us the first pair of siblings to have the same problem that ISN’T genetic. That’s kinda cool I guess. The doctors were completely baffled as to how we both had the same issue. His was found when he was three weeks old. Mine? 

I was fucking ten. 

>:( 

And there was a draining tube stuck in my side right under the place where they went in and there was an IV in my fucking hand and every other godawful thing that haunts any other ten year old’s nightmares. 

However, it saved my life. And I wouldn’t be here today if the school nurse hadn’t urged my parents to get me checked out. So, kudos for her. <3 

Anyways. The more you know I s'pose. Now when I say I’m having chest issues or aches or whatever, you know I am not kidding around and there should be something done. It doesn’t hurt to tell me to calm my ass down guys. XD 

Flare 4

Part 4 for the 4th… not as many fireworks here perhaps as in U.S. skies tonight, but we are certainly taking steps in that direction. Plenty of cute, though, given that there is a kitten involved. (I think I will include deathtodickens in the blame for the fact that I am currently giving consideration to Dickens in not only this story but also “Mercury.”) Fires started in amatterofcomplication’s masterpost, continuing in/through part 1, part 2, and part 3.

Flare 4

Helena learns, over the next several hours, that cats are in fact nocturnal. Because while small Mr. Dickens had seemed quite contentedly asleep in the firehouse, he seemed to realize, upon entering Helena’s apartment, that night had fallen. And night means exploration and the hunt. He has explored the kitchen (conclusion: boring, with too-slick floors; Helena thinks she will need to purchase a carpet if she wants him to have his chow there, which she does indeed, because he has already scattered it everywhere, for apparently cats being fastidious = myth propagated to encourage cat ownership), the living-room bookshelves (first two levels of each bookcase: very intriguing smells; any above: unreachable at present), and her television cabinet (far too dusty, productive of sneezing; Helena agrees and considers that she should just get rid of the thing and what it contains).

Keep reading

7

Welp, I’ve kinda thought about it for a while and I’ve realized that I’m only calm and happy when I’m taking care of someone or something. Unfortunately, both of my cats, Salem and Koga, have been stolen. Since this happened, I’ve noticed my panic attacks have picked up and I’m constantly having thoughts that nobody needs or wants me. I don’t have anything to cuddle with or take care of. 

Not only this, but it’s become increasingly dangerous for me to have panic attacks. When I was ten, I was diagnosed and treated for a Coarctation of the Aorta. Which means that the main aortic arch was closed off almost, meaning I was getting next to no bloodflow to my lower body, and too much to my upper body, causing major blood pressure problems for me. Since I was ten they couldn’t use a vein from my arm like they did in my little brother, so instead they had to use a rubber tube. And I’ve grown alot since I was ten. Here lately the symptoms have come back. And my pulse is skyrocketing so bad that I’m no longer able to donate blood. One bad panic attack could cause me to have a stroke. [Mind you I am only twenty-one] I go in April to find out just what is going on inside me and if I’ll have to have the surgery completely redone to adjust the size of the tubing. I’m terrified to be honest. Because I fully understand what’s going to happen if anything goes wrong this time. I’m not a big fan of doctors, tbh. 

So I’ve decided that maybe I should get something to filter my anxieties [and hopefully help me keep myself at a mellow point at all times]: A bunny. This would become my constant companion. My cousin has a dachshund that she goes everywhere with and she’s told me it helps to have something like that that will constantly need you but not ever treat you the way people will. A bunny seems manageable enough that I think it’d be easier for me to take care of and take everywhere instead of a dog or a cat. 

So here is where I need help. I’m accepting commissions [and every little bit helps!] to take care of the expenses and make sure I have a perfect environment for my little companion. I’ll post pictures regularly and even allow you guys to help me name it! I just desperately need help to make sure he or she will be safe, healthy, and happy.

 Price List: [All Prices are negotiable!]

  • Sketches: $5.00
  • Linearts: $10.00
  • Colored Busts: $15.00
  • Shaded/No background: $15.00
  • Shaded/Simple background: $20.00
  • Shaded/Detailed background: $30.00-$50.00 (Depending on detail.)
  • Ref. Sheets: Prices differ.
  • Chibi: $10.00
  • Extra Character: $5.00 each

Have an OC but no icons of them? I also do expression sheets/icon sheets for $25.00! I’ll even make them into an icon pack for you. 

Donations help too, but I figure it would really be nice if I could do something for you in return. Signal Boosting and spreading the word for me would be amazing. Thank you for helping if you do and thank you for signal boosting. 

You can contact me here: sweetlittlesunflower or ringtailcutie