Patent Ductus Arteriosus
From Anvita Health Wiki
Contents |
Introduction
- Congenital anomaly resulting from failure of the ductus arteriosus to close after birth.
Etiology
Pathology
- arteriovenous fistula
- small ductus compatible with normal life span
- ductus may calcify in adult life
- large patent ductus arteriosus may cause significant left-to-right shunt, with left sided cardiac chamber enlargement & result heart failure
- may produce elevated pulmonary pressure & pulmonary vascular disease
Clinical-manifestations
- may be asymptomatic
- retarded growth
- exertional dyspnea
- murmur spanning the entire cardiac cycle
- machinery-like in quality
- late systolic accentuation
- loudest in the 2nd intercostal space beneath left clavicle
- collapsing pulse (large shunt)
- high pulse pressure (large shunt)
- adults may present with:
- cyanosis & clubbing of feet > hands
- heart failure [3]
Radiology
- pulmonary artery opacification on aortogram
- prominent pulsating lung markings
- echocardiogram
Management
- surgery is curative
- endocarditis prophylaxis not needed after surgery
More General Terms
Additional Terms
References
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 46
- DeGowin & DeGowin's Diagnostic Examination, 6th edition, RL DeGowin (ed), McGraw Hill, NY 1994, pg 880
- Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
- National Guideline Clearinghouse
- Patent ductus arteriosus. In: ACC/AHA 2008 guidelines for the management of adults with congenital heart disease. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). ngc-guideline: [1]
