2 - Paeds - CVS - Persistent DA

Question 1

define a PDA

Answer 1

failure to close DA 1m after term due to constrictor mechanism defect

Question 2

function of DA

Answer 2

no blood needed in lungs, blood to pulm artery crosses DA into aorta
when born systemic res increases -> left side of heart ^^ in pressure x6 -> closes foramen ovale

DA now has blood flowing in opp direction and should close soon

Question 3

Clinical features?

Answer 3

continuous murmur below L clavicle - continues to diastole as aortic pressure is always higher

increased pulse pressure > collapsing/bounding pulse

Question 4

Sx?

Answer 4

unusual unless large duct > inc pulm bf, HF, pulm HTN

Question 5

Ix?

Answer 5

CXR and ECG usually normal
if large duct….abnormalities indistinguishable from large VSD

seen on ECHO

Question 6

MGMT

Answer 6

1y closure - coil/occlusion device from cardiac catheter, to stop lifelong risk of bact endocarditis and pulm vascular disease. Occasionally ligation