Patent ductus arteriosus An overview

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 oxygen-rich (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 LT VENT-DELAYED CLOSURE OF AORTIC VALVE DILATATION OF ASCENDING AORTA LATE A2 PARADOXICALLY 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/GIBSONS/TRAIN-IN-TUNNEL 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