Patent ductus arteriosus

DEFINITIONPatent 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 oxygen-rich (red) blood that should go to the body to re-circulate through the lungs

IN DEPTH

IN GROSS

HEMODYNAMICSLT TO RT SHUNT OCCURS BOTH DURING SYSTOLE & DIASTOLE LARGE AMT OF BLOOD PASSES THRU PULM ART-LT ATRIUM MITRAL VALVECONTINOUS MURMUR

ACCENTUATED S1MITRAL DELAYED DIASTOLIC MURMUR

HEMODYNAMICS LARGE FLOW THRU LT VENT-DELAYED CLOSURE OF AORTIC VALVE DILATATION OF ASCENDING AORTA LATE A2PARADOXICALLY SPLIT S2

AORTIC EJECTION CLICKAORTIC EJECTION SYSTOLIC MURMUR

PRESENTATIONFrequent chest infectionsfatiguesweating rapid breathing heavy breathing congested breathing disinterest in feeding, or tiring while feeding poor weight gain

ON EXAMINATIONINSPECTIONCAROTID PULSATIONSHYPERKINETIC & LT VENTRICULAR TYPE OF APICAL IMPULSE

PALPATIONSYSTOLIC OR CONTINOUS THRILL AT 2ND LT INTERSPACE

AUSCULTATION ACCENTUATED S1NARROWLY OR PARADOXICALLY SPLIT S2 LOUD P2CONTINOUS MURMUR BEST HEARD IN INFRACLAVICULAR REGIONMITRAL DELAYED DIASTOLIC MURMUR

CXR FINDINGSCARDIOMEGALYLA ENLARGEMENTLV ENLARGEMENTPROMINENT AORTIC KNUCKLEPULM PLETHORA

ECG CHANGES NORMAL AXIS WITH LT VENTRICULAR HYPERTROPHY

ECHO PICTURES

MANAGEMENTMEDICALINDOMETHACIN 0.1 mg/kg/dose,orally,bd for three dosesDigoxin for increasing working capacity of heartDiuretics to reduce preload on heart

SURGICAL REPAIR :DEVICES

REPAIR