Finding
These older patients do not develop symptoms of severe congestive heart failure because the slower constriction allows time for compensitory myocardial hypertrophy, preventing a sudden increase in left ventricular afterload and a decrease in left ventricular output.
Paper
Aortic obstructions in infants and children: Pathophysiology and clinical presentation of coarctation of the aorta
Abstract
Summary The pathophysiology and hemodynamics of isolated coarctation of the aorta can be explained best in terms of constriction of the aortic end of the ductus arteriosus. This typically occurs at 7 to 14 days of age in neonates who present with symptoms. A slower, more gradual constriction of the ductus, with its tissue extending into the lumen of the aorta, probably occurs in patients who present as older infants, children, or adolescents. These older patients do not develop symptoms of severe congestive heart failure because the slower constriction allows time for compensitory myocardial hypertrophy, preventing a sudden increase in left ventricular afterload and a decrease in left ventricular output.
Authors
T. Graham, J. Johns
Journal
Progress in Pediatric Cardiology