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 Playback

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

//embedding heart 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

These authors contributed the audio recordings and text found in this reference guide: Jon Keroes, MD,Diane Wrigley, PA, and David Lieberman.
Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.

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