PATENT
DUCTUS ARTERIOSUS (PDA)
DEFINITION
- Fetal connection between aorta and pulmonary artery persist (PDA)
EPIDEMIOLOGY
- 5- 10% of all congenital heart disease.
- Increase incidence in premature infants.
PATHOPHYSIOLOGY
- Left to right shunt with left ventricular volume overload.
CLINICAL
SIGNS AND SYMPTOMS
- Symptoms depend on the size of the PDA.
- Asymptomatic to congestive heart failure (particularly in preemies)
- Machinery type murmur best heart at the upper left sternal border
- Bounding pulses with wide pulse pressure (large defect)
- Echo confirm suspicion, determine size, location, pulmonary artery pressures
- EKG range from normal to left ventricular hypertrophy, right ventricular hypertrophy (depends on size of defect)
- Chest X ray normal to cardiomegaly with increase pulmonary vascular markings
 |
| Echo in PDA |
MEDICAL
MANAGEMENT
- Diuretics
- Ibuprofen
SURGICAL
MANAGEMENT
- Ligation/ surgical clip: (L) thoracotomy or video assist thorascopic surgery
- Ductus occlusive device
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