Heart Failure et causa Moderate Large Patent Ductus Arteriosus

in Children 8 years old

Rahmat Alfath1 ; H Faradilah2
1
General Practitioner in RSUD Bangkinang, Kampar, Indonesia;
2
Pediatrician in RSUD Bangkinang, Kampar, Indonesia
Background

The Ductus Arteriosus is the vessel that connects the pulmonary artery to the descending aorta during
fetal life. Patent Ductus Arteriosus results when the ductus fails to close after birth, resulting in a
persistent connection between the great vessels.

Case Description

A girl, 8 years old, was presented in emergency departement with dyspnea,for 2 months, and
worse if do activity. She has been fever for 4 months. She got Cough with clear sputum. She
didn’t has cyanosis hystory. She had poor appetite.

On physical examination, Blood Pressure was 102/69mmHg, Heart Rate was 112 b.p.m regular,
and Respiratory Rate was 38 b.p.m, SpO 2 94%, Temperature was 38,3C, The Weigh was 17kg. Chest
examination was found Pansistolic Murmur grade 4 in 2nd left ICSPSL and 4th left ICSMCL

Admission ECG showed Sinus Tachycardi and Left Ventricel Hypetrophy. The Chest X-Ray showed
Cardiomegaly (left atrial and left ventricular enlargement) with prominent pulmonary vascular..
Labolatory finding were Hb:10gr% Leu:19.800 Ht:30,4% Tr:396.000 Gds:133

Ro Thorax

Diagnosis: CHF NYHA II-III ec Susp. CHD + Bronchopneumonia

Therapy: Pro PICU Furosemid 1x18mg

 O2 2-3L/i,Semi Fowler Spironolacton 2x12,5mg

Inj.Cefotaxim 900mg/12h Paracetamol Syr 3x1,5cth

Planing Echocardiography

Echocardiography

Dilated LA, LV. Moderate-large PDA 5.5mm. Shunting L to R. Mild MR, mild PI. Dilated
branch PA’s.

Diagnosis : Moderate-Large PDA

Plan/ Suggestion : - Furosemid 1x15mg - Spironolacton 2x12,5mg

- Captopril 3x6.25mg

Pro Transcatheter Closure of PDA

Discussion

Heart Failure in Children is rare condition, specially Patent Ductus Arteriosus, sometimes
comes with no symptoms or similiar with pulmonary infection and didn’t detected in
neonatus. Early diagnosis and effective treatment will increase survival rate. Transcatheter
closure of PDA once sign of lung overflow is controled.

Conclusion

Hear Failure in Children needs early diagnosis and effective treatment.

Keywords

Heart Failure, Congenital Heart Disease, Patent Ductus Arteriosus, Children