Aortic coarctation was one of the first types of congenital heart diseases to be treated successfully with surgery. Despite initial optimism, surgical relief of aortic narrowing does not cure the underlying vascular problem. Patients with previously repaired coarctation have a significantly reduced life expectancy and continue to be at risk of major complications throughout life including hypertension, aortic aneurysms, premature coronary artery disease, aortic valve problems, and cerebral aneurysms.^1,2 In addition female patients are at particular risk during pregnancy and childbirth.³ All patients with previously repaired aortic coarctation require careful life long follow up.^2,4 Without follow up they may present too late with untreated hypertension or with catastrophic complications such as aortic dissection. Although aortic coarctation may be dismissed as a rare condition of little general interest, most primary care groups in the UK will have at least one patient with aortic coarctation.

We carried out a notes based study …