5
            
            
              What is coarctation
            
            
              of the aorta?
            
            
              Coarctation of the aorta—or aortic
            
            
              coarctation—is a narrowing of
            
            
              the aorta, the large blood vessel
            
            
              that branches off your heart and
            
            
              delivers oxygen-rich blood to
            
            
              your body. When this occurs, your
            
            
              heart must pump harder to force
            
            
              blood through the narrow part
            
            
              of your aorta. Coarctation of the
            
            
              aorta is generally present at birth
            
            
              (congenital) and may range from
            
            
              mild to severe.
            
            
              Within
            
            
              two days,
            
            
              Clay
            
            
              underwent
            
            
              surgery. A few
            
            
              days later, an
            
            
              echocardiogram found
            
            
              that another coarctation
            
            
              had formed and surgery
            
            
              was set for five weeks after his
            
            
              discharge.
            
            
              Tessa and her husband, Eric, spent
            
            
              13 days with Clay at Children’s before
            
            
              he was able to come home.
            
            
              “We saw the Children’s doctors
            
            
              weekly at the Richland clinic,” said
            
            
              Tessa. “At the third visit, just two weeks
            
            
              before his next surgery, his heart flow
            
            
              was really good. It had cleared itself.
            
            
              They said that never happens. Surgery
            
            
              was cancelled.”
            
            
              When Clay is a teenager, he may
            
            
              have to have surgery, but for now, the
            
            
              Hansons can think about other things
            
            
              like watching him grow like any other
            
            
              baby.
            
            
              “It was the care that Cynthia took
            
            
              in examining Clay that helped her find
            
            
              what was going on and saved his life,”
            
            
              said Tessa. “They told us in Seattle, that
            
            
              had it not been found, he would have
            
            
              gone into cardiac arrest within a couple
            
            
              of days.
            
            
              “It was really hard with ups and
            
            
              downs, but we all made it and he’s doing
            
            
              really well,” she said.
            
            
              For Ironside, the relationship with
            
            
              the Kadlec’s pediatric hospitalists
            
            
              was important in getting Clay treated
            
            
              promptly and appropriately. “The
            
            
              pediatric hospitalists are fantastic. I can
            
            
              call and talk to them about situations I
            
            
              am concerned about. They are very good
            
            
              at what they do. It is wonderful to have
            
            
              a relationship with them and in Clay’s
            
            
              case, it made a big difference.
            
            
              “Clay was a lucky little guy,” said
            
            
              Ironside. “Everything worked out just
            
            
              right for him that day.”
            
            
              Coordination of care proves critical
            
            
              W
            
            
              WHEN TESSA HANSON took her
            
            
              tiny new son Clay in for his two-week
            
            
              well checkup with Cynthia Ironside, a
            
            
              certified pediatric nurse practitioner at
            
            
              Kadlec Clinic Pasco Primary Care, she
            
            
              had no idea about how the life of her
            
            
              family was about to change.
            
            
              But Ironside’s desire to find answers
            
            
              as to why little Clay was having
            
            
              difficulty breathing, had an elevated
            
            
              heart rate and lack of femoral (inner
            
            
              thigh) pulse, started the family on an
            
            
              often scary, but successful journey.
            
            
              “When I couldn’t find Clay’s femoral
            
            
              pulse, I suspected a coarctation of the aorta,
            
            
              which is a narrowing of the descending
            
            
              aorta and very serious,” said Ironside. “I
            
            
              called in Dr. (Aaron) Richardson from
            
            
              our office to examine him as well and he
            
            
              could not find the femoral pulse either.
            
            
              That’s a big red flag.”
            
            
              Tessa watched as Ironside “examined
            
            
              him very carefully. She then sent us to
            
            
              get chest X-rays,” said Tessa.
            
            
              “The X-rays indicated there was
            
            
              pneumonia,” said Ironside, “so I knew
            
            
              he needed to be hospitalized. But I
            
            
              also called Dr. (Stacey) Hedlund in the
            
            
              Pediatric Center and told her about
            
            
              Clay’s lack of femoral pulse.”
            
            
              Once Tessa got Clay to Kadlec’s
            
            
              Don and Lori Watts Pediatric Center,
            
            
              Dr. Hedlund, one of Kadlec’s pediatric
            
            
              hospitalists, examined him and
            
            
              ordered additional tests including an
            
            
              echocardiogram.
            
            
              “When the results came back, the
            
            
              doctor sat us down and said Clay had a
            
            
              coarctation of the aorta and that it is a
            
            
              life-threatening condition,” said Tessa.
            
            
              Within minutes, Dr. Hedlund
            
            
              arranged for Clay to be transported by
            
            
              airplane to Seattle Children’s Hospital.
            
            
              Meanwhile, she started him on
            
            
              medication to help get a better blood
            
            
              supply to his lower extremities and he
            
            
              was put on a respirator.
            
            
              Clay
            
            
              Saving
            
            
              Tessa Hanson, left, holds her son Clay.
            
            
              She is joined by her daughter Kiley and
            
            
              Cynthia Ironside, CPNP, who made a
            
            
              diagnosis which saved Clay’s life when
            
            
              he was just days old.