Patent Ductus Arteriosus

Question 1

What is this?
→ What’s the normal progress of the DA after birth?

What’s a key risk factor here?

What does this lead to?

Answer 1

➊ When DA remains patent after 4wks
→ Normally stops functioning 1-3 days after birth and closes within the first 2-3 weeks

➋ Prematurity

➌ • L-R shunt as blood flows from aorta into pulmonary arteries – This causes Pulmonary HTN, leading to RH strain and hypertrophy
• The increasing blood flow returning from the pulmonary circulation leads to LV hypertrophy as well

Question 2

How does it present?

Only when is it managed?

How is it managed?

Answer 2

➊ • Continuous crescendo-decrescendo machine-whirring murmur
• SOBOE
• Poor feeding and weight gain
• LRTIs

➋ If symptomatic

➌ • Echo for monitoring
• Medical – NSAIDs, which inhibit prostaglandin synthesis and close PDA
• Surgical repair done