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Patent Ductus Arteriosus
Aka: Patent Ductus Arteriosus
- See also
- Congenital Heart Disease
- Congenital Heart Disease Causes
- Epidemiology
- Incidence: 12% of Congenital Heart Defects
- Affects 20-60% of Premature Infants
- Females affected twice as often as males
- Risk Factors
- Maternal residence at high altitude
- Rubella exposure in the first timester
- Pathophysiology
- Failure after birth of obliteration ductus arteriosus
- Leaves communication between aorta and pulmonary artery
- Symptoms (may be asymptomatic)
- Growth retarded
- Exertional Dyspnea
- Signs
- Machinery murmur throughout Cardiac Cycle
- Late systolic accentuation of murmur
- Left second interspace
- Left back
- Large shunt related findings
- Collapsing Pulse
- High Pulse Pressure
- Diagnostics: Electrocardiogram
- Large PDA
- Left Ventricular Hypertrophy
- Pulmonary Hypertension
- Right Ventricular Hypertrophy
- Biventricular hypertrophy
- Imaging
- Chest XRay
- Cardiomegaly
- Increased pulmonary markings
- Echocardiogram
- Identify PDA on doppler flow
- Aortogram
- Accentuated pulmonary conus
- Prominent pulsating lung markings
- Pulmonary artery opacification
- Management
- Premature Infant (requires urgent management)
- Indomethacin
- Surgical ligation or transvenous Occlusion
- Child
- Surgical ligation or transvenous Occlusion
- References
- Saenz (1999) Am Fam Physician 59(7):1857-66 [PubMed]
- Cyran (1998) PREP review lecture, October, Phoenix
- Merenstein (1994) Pediatrics, Lange