Patent Ductus Arteriosus

Relevant Physiology

Pathogenesis

• L → R shunt (from aorta to pulmonary trunk)
• Increased Pulmonary Blood Flow (PBF) → PH - Pulmonary hypertension
• LA, LV dilation

Prognosis/Disease Course/Complications

• Most closes spontaneously
• Large
  • CHF
  • failure to thieve
  • pulmonary hypertension
  • Eisenmenger Syndrome over time

Presentation

Signs and Symptoms

• Ranges from asymptomatic to CHF
• Decreased diastolic pressure (as some blood enters pulmonary circulation during diastole) → more palpable, bounding pulse

Precordial Exam: murmur

• Continuous (machinery) murmur at LUSB
• Louder during systole

https://www.youtube.com/watch?v=Fm5xgS1xOOc

Management

Asymptomatic: spontaneous closure