Patent Ductus Arteriosus (PDA)
Definition
Epidemiology
5-10% of all congenital heart defects
Clinical Features
Symptoms
Treatment
Source
Toronto Notes 2012
- Patent vessel between descending aorta and left pulmonary artery
- Functional closure within first 15 h of life, anatomical closure within first days of life
- Delayed closure of ductus is common in premature infants (1/3 of infants <1750 grams); this is different from PDA in term infants
Epidemiology
5-10% of all congenital heart defects
Clinical Features
Symptoms
- May be asymptomatic, or have apnoeic or bradycardic spells, poor feeding, accessory muscle use
- Tachycardia, bounding pulses
- Hyperactive precordium
- Wide pulse pressure
- Continuous "machinery" murmur best heard at left infraclavicular area
- ECG: may show LAE, LVH, RVH (diagnosis made by ECG)
- CXR: normal to mildly enlarged heart, increased pulmonary vasculature, prominent pulmonary artery
Treatment
- Indomethacin (Indocid®) - PGE2 antagonist (PGE2 maintains ductus arteriosus patency) only effective in premature infants if necessary
- Catheter or surgical closure if PDA is contributing to respiratory compromise, poor growth or persists beyond 3rd month of life
Source
Toronto Notes 2012