Patent ductus

arteriosus

DEFINITION
Patent ductus arteriosus
(PDA) is a heart
problem that is usually
noted in the first few
weeks or months after
birth. It is characterized
by a connection
between the aorta and
the pulmonary artery,
which allows oxygenrich (red) blood that
should go to the body
to re-circulate through
the lungs

IN DEPTH

IN GROSS

HEMODYNAMICS
LT TO RT SHUNT

OCCURS BOTH
DURING SYSTOLE
& DIASTOLE
LARGE AMT OF
BLOOD PASSES
THRU PULM ART-LT
ATRIUM MITRAL
VALVE

CONTINOUS
MURMUR

ACCENTUATED S1
MITRAL DELAYED
DIASTOLIC
MURMUR

HEMODYNAMICS
LARGE FLOW THRU LATE A2
LT VENT-DELAYED
PARADOXICALLY
CLOSURE OF
AORTIC VALVE
DILATATION OF
ASCENDING AORTA

SPLIT S2

AORTIC EJECTION

CLICK
AORTIC EJECTION
SYSTOLIC MURMUR

PRESENTATION
Frequent chest infections
fatigue
sweating
rapid breathing
heavy breathing
congested breathing
disinterest in feeding, or tiring while feeding
poor weight gain

ON EXAMINATION
INSPECTION
CAROTID

PULSATIONS
HYPERKINETIC & LT
VENTRICULAR TYPE
OF APICAL IMPULSE

PALPATION
SYSTOLIC OR

CONTINOUS THRILL
AT 2ND LT
INTERSPACE

AUSCULTATION
ACCENTUATED S1
NARROWLY OR PARADOXICALLY SPLIT

S2
LOUD P2
CONTINOUS MURMUR BEST HEARD IN
INFRACLAVICULAR REGION
MITRAL DELAYED DIASTOLIC MURMUR

CXR FINDINGS
CARDIOMEGALY
LA ENLARGEMENT
LV ENLARGEMENT
PROMINENT
AORTIC KNUCKLE
PULM PLETHORA

ECG CHANGES
NORMAL AXIS WITH LT VENTRICULAR
HYPERTROPHY

ECHO PICTURES

MANAGEMENT
MEDICAL
INDOMETHACIN 0.1

mg/kg/dose,orally,bd for three doses

Digoxin for increasing working
capacity of heart
Diuretics to reduce preload on heart

SURGICAL REPAIR :DEVICES

REPAIR