Coarctation of the Aorta

This is an example of coarctation of the aorta, a congenital abnormality. This first heart sound is normal. The second heart sound is intensified. There is diamond shaped murmur occupying most of systole and a high-pitched decrescendo murmur in the first half of diastole. In the anatomy video you can see a constriction in the descending aorta which is responsible for the systolic murmur. There is regurgitant flow from the aorta into the left ventricle which causes the diastolic murmur. The left ventricle wall thickness is increased due to aortic pressure elevation caused by the aortic coarctation.

Auscultation Sounds

Patient Recording

Patient Recording - Half Speed

Position

The patient's position should be sitting leaning forward.

Listening Tips

Systole:Diamond-shaped murmur, possible early systolic ejection sounds
S2:Increased intensity
Diastole:high-pitched, decrescendo, early murmur

Waveform (Phonocardiogram)

Observe Cardiac Animation

Play the cardiac movie and observe a constriction in the descending aorta which is responsible for the systolic murmur. There is regurgitant flow from the aorta into the left ventricle which causes the diastolic murmur. The left ventricle wall thickness is increased due to aortic pressure elevation caused by the aortic coarctation.

Authors and Sources

Authors and Reviewers

EKG heart rhythm modules: Thomas O'Brien.
EKG monitor simulation developer: Steve Collmann
12 Lead Course: Dr. Michael Mazzini, MD.
Spanish language EKG: Breena R. Taira, MD, MPH
Medical review: Dr. Jonathan Keroes, MD
Heart sounds and mentorship: W. Proctor Harvey, MD
Medical review: Dr. Pedro Azevedo, MD, Cardiology
Last Update: 1/8/2023

Sources

Electrocardiography for Healthcare Professionals, 5th Edition Kathryn Booth and Thomas O'Brien
ISBN10: 1260064778, ISBN13: 9781260064773
McGraw Hill, 2019
Rapid Interpretation of EKG's, Sixth Edition
Dale Dublin
Cover Publishing Company
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Aaron Reed
Create Space Independent Publishing
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN
Clinical Heart Disease W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009)
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429
Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH

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Coarctation of the Aorta | Lessons with Audio and Video | #107