Which cardiac drugs may be implicated in the pathophysiology of coarctation of the aorta (CoA)?

Updated: Nov 20, 2018
  • Author: Syamasundar Rao Patnana, MD; Chief Editor: Stuart Berger, MD  more...
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Drugs typically used to treat patients with CHF, such as angiotensin-converting enzyme (ACE) inhibitors and, more recently, angiotensin II antagonists, may have adverse effects in patients with coarctation of the aorta. Attempts to achieve a normal precoarctation BP with these drugs may result in inadequate lower-body perfusion and may precipitate renal failure.

Vasopressin is also increased in heart failure, although its major stimulus for release is angiotensin II. Vasopressin affects free water retention and may result in hyponatremia. The vasoconstrictive properties of vasopressin may further elevate BP in coarctation.

Other substances, such as human brain natriuretic peptide (BNP), an endothelin, may be activated by CHF, although their specific role in coarctation has not been studied.

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