Wellbutrin (Bupropion) & Coarctation of the Aorta

Aortic coarctation is a narrowing of part of the aorta (the major artery leading out of the heart). It is a type of birth defect. Coarctation means narrowing.

Causes

The aorta carries blood from the heart to the vessels that supply the body with blood and nutrients. If part of the aorta is narrowed, it is hard for blood to pass through the artery.

Aortic coarctation is more common in persons with certain genetic disorders, such as Turner syndrome. However, it can also be due to birth defects of the aortic valves. Many factors, including the use of antidepressant medications such as Wellbutrin during pregnancy, seem to be involved. Aortic coarctation is one of the more common heart conditions present at birth (congenital heart conditions). It is usually diagnosed in children or adults under age 40.

Coarctation of the aorta may be seen with other congenital heart defects, such as:

Bicuspid aortic valve
Defects in which only one ventricle is present
Ventricular septal defect

Symptoms

Symptoms depend on how much blood can flow through the artery. Other heart defects may also play a role. Around half of newborns with this problem will have symptoms in the first few days of life. In milder cases, symptoms may not develop until the child has reached adolescence. Symptoms include:

Dizziness or fainting
Shortness of breath
Pounding headache
Chest pain
Cold feet or legs
Nosebleed
Leg cramps with exercise
High blood pressure (hypertension) with exercise
Decreased ability to exercise
Failure to thrive
Poor growth

Note: There may be no symptoms.

Exams and Tests

The health care provider will perform a physical exam and take your blood pressure and pulse in your arms and legs. The pulse in the femoral (groin) area or feet will be weaker than the pulse in the arms or the carotid (neck). Sometimes, the femoral pulse may not be felt at all. The blood pressure in your legs is usually weaker than in the arms. Blood pressure is usually higher in the arms after infancy. The doctor will use a stethoscope to listen to your heart and check for murmurs. People with aortic coarctation have a harsh-sounding murmur that can be heard from the back. Other types of murmurs may also be present. Coarctation is often discovered during a newborn's first examination or well-baby exam. Taking the pulses in an infant is an important part of the examination, because there may not be any other symptoms or findings until the child is older.

Tests to diagnose this condition include:

Echocardiography is the most common test to diagnose this condition, and it may also be used to monitor the patient after surgery
Chest x-ray
Heart CT may be needed in older children
MRI or MR angiography of the chest may be needed in older children
Cardiac catheterization and aortography
Both Doppler ultrasound and cardiac catheterization can be used to see if there are any differences in blood pressure in different areas of the aorta

Treatment

Most newborns with symptoms will have surgery either right after birth or soon afterward. First they will receive medications to stabilize them. Children who are diagnosed when they are older will also need surgery. Usually, the symptoms are not as severe, and more time will be taken to plan for surgery. During surgery, the narrowed part of the aorta will be removed or opened. If the problem area is small, the two free ends of the aorta may be re-connected. This is called anastomosis. If a large part of the aorta is removed, a Dacron graft (a man-made material) or one of the patient's own arteries is used to fill the gap. A tube graft connecting two parts of the aorta may also be used. Sometimes, balloon angioplasty may be done instead of surgery, but it has a higher rate of failure. Older children usually need medicines to treat high blood pressure after surgery. Some will need lifelong treatment for this problem.

Prognosis

Coarctation of the aorta can be cured with surgery. Symptoms quickly get better after surgery. However, there is an increased risk for death due to heart problems among those who have had their aorta repaired. Without treatment, most people die before age 40. For this reason, doctors usually recommend that the patient has surgery before age 10. Most of the time, surgery to fix the coarctation is done during infancy. Narrowing or coarctation of the artery can return after surgery. This is more likely in persons who had surgery as a newborn.

Possible Complications

Complications that may occur before, during, or soon after surgery include:

Aortic aneurysm
Aortic dissection
Aortic rupture
Bleeding in the brain
Endocarditis (infection in the heart)
Heart failure
Hoarseness caused by injury to the nerve to the larynx
Impaired kidney function
Paralysis of the lower half of the body (rare complication of surgery to repair coarctation)
Premature development of coronary artery disease (CAD)
Severe high blood pressure
Stroke

Long-term complications include:

Continued narrowing of the aorta
Endocarditis (infection in the heart)
High blood pressure

Prevention

There is no known way to prevent this disorder; however, being aware of your risk may make early diagnosis and treatment possible. Many factors, including the use of antidepressant medications during pregnancy, seem to be involved.

Alternative Names

Aortic coarctation

Speak to a Wellbutrin Lawyer about a Wellbutrin Birth Defect Lawsuit

If your child was born with a severe birth defect that may have resulted from your being prescribed Wellbutrin during pregnancy, please contact our law firm immediately to discuss your legal rights to file an individual Wellbutrin Lawsuit and for information regarding a Wellbutrin Class Action Lawsuit. Please keep in mind that certain states have filing deadlines or statute of limitations that limit the amount of time you have to file a lawsuit or seek legal action. Speak to a Wellbutrin lawyer if your child has been born with Coarctation of the Aorta, required open heart surgery, or required a heart transplant to correct a Wellbutrin related congenital birth defect.

Our law firm has represented thousands of clients over the past twenty five years and thoroughly understands pharmaceutical product-liability and drug litigation. You are not alone. Contact us today for a free and completely confidential Wellbutrin Side Effects lawsuit evaluation. Talk to a Wellbutrin Lawyer now about your rights. Fill our our online form on the right, or call our law firm toll free at (800) 883-9858.