Patent Ductus Arteriosus

Question 1

Define Patent Ductus Arteriosus

Answer 1

a congenital heart defect in which the ductus arteriosus, a blood vessel that normally connects the pulmonary artery to the aorta in fetal life, fails to close after birth

Question 2

What shunt is PDA?

Answer 2

L-R shunt

Question 2

When do the Ductus Arteriosus normally closes?

Answer 2

first 24 to 72 hours of birth

Question 3

What murmur is auscultated in PDA?

Answer 3

Continuous (throughout systole + diastole), machinery-like murmur

Question 4

Where is the murmur for PDA best heard?

Answer 4

Infraclavicular or L upper sternal edge

Question 5

Moderate PDA clinical presentations

Answer 5

• Tachypnoea
• poor feeding
• mild respiratory distress
• failure to thrive
• fatigue

Question 6

Large / severe PDA clinical presentations

Answer 6

• HF Sx
• Poor feeding
• pulmonary HTN
• Cyanosis
• R-L shunt

Question 7

What keeps the ductus arteriosus patent in feotus

Answer 7

prostaglandin E2

Question 8

What vessels are involved in PDA

Answer 8

Aorta and pulmonary aretery

Question 9

Mx for preterm infants w/ symptomatic PDA

Answer 9

1st line Tx = Indometacin to promote closure of the DA

prostaglandin inhibitors

Question 10

What is the character of the pulse in PDA infants

Answer 10

Collapsing pulse: increased pressure gradients and a continuous murmur from turbulent flow across the ductus arteriosus