In his first months of life, Caden Jacobson slept a lot more than his mother, Amanda, thought was normal. He mostly ate and slept, and he wasn’t growing much either.
A first-grade teacher from Wooster, Amanda knew something was not right. Numerous trips to doctors didn’t point to any medical causes for Caden’s lethargy. But around Thanksgiving 2017, a chest X-ray during an ER visit for what was thought to be a respiratory virus showed that Caden’s heart was enlarged.
At 4 months old, Caden was brought to Akron Children’s Heart Center‘s Specialty Care location in Wooster for further evaluation. Pediatric cardiologist Dr. Brandon Smith detected a heart murmur on Caden’s examination, and a subsequent ultrasound showed his heart function was poor. The cause: A congenital defect of the aorta, the large artery that carries blood from the heart to the rest of the body. The defect, called coarctation of the aorta, is a narrowing of the artery. The condition impaired his heart’s pumping ability.
Unfortunately, this defect is not always detected in newborn pulse oximetry screening for critical congenital heart defects.
Coarctation of the aorta may be missed in newborn screening about 40% of the time, Dr. Smith said.
“His heart was failing,” said Dr. Smith. “It wasn’t tolerating the coarctation. The left ventricle (the pumping chamber) was dilating. The way it was squeezing was poor.”
Amanda and her husband, Zach, were suddenly dealing with an emergency.
“Dr. Smith drew a picture, explained what was happening and said we need to go to the PICU (pediatric intensive care unit) right now,” Amanda recalled.
When they got to Akron Children’s Pediatric Critical Care, a team was waiting for them. Doctors gave Caden medication to stabilize his heart. The next day, he underwent surgery to repair his aorta. He spent the next 10 days in the PICU.
Amanda and Zach saw a difference in their son right away. His face looked healthier. He was animated and moving. Two days after surgery, Caden was playing with a little ball between his feet. He had never done that before.
Today, at 18 months, he scampers around with older brother Luke at Cloud 9 Playspace in downtown Wooster. During a recent visit, Amanda showed a video of Caden starting to crawl on the carpeting 2 months after surgery. Luke can be heard in the background yelling, “You can do it!”
“Caden is doing well,” said Dr. Smith, who sees Caden for follow-up care at the Wooster clinic. “He doesn’t have any heart symptoms. His ventricular function is fine.”
Coarctation of the aorta is present in about 1 in 2,500 babies born in the United States every year, according to the U.S. Centers for Disease Control and Prevention.