pda Flashcards
What is patent ductus arteriosus?
A form of congenital heart defect generally classed as ‘acyanotic’.
What can uncorrected patent ductus arteriosus lead to?
Late cyanosis in the lower extremities, termed differential cyanosis.
What is the connection involved in patent ductus arteriosus?
The connection between the pulmonary trunk and descending aorta.
When does the ductus arteriosus usually close?
With the first breaths due to increased pulmonary flow which enhances prostaglandins clearance.
In which populations is patent ductus arteriosus more common?
Premature babies, born at high altitude or maternal rubella infection in the first trimester.
What are the characteristic features of patent ductus arteriosus?
Continuous ‘machinery’ murmur, large volume bounding pulse, wide pulse pressure, heaving apex beat.
What is the typical management recommendation for preterm infants with patent ductus arteriosus?
Initial expectant supportive care rather than early pharmacologic therapy.
What is recommended if hemodynamically significant PDA remains in preterm infants?
Pharmacological closure using ibuprofen, indomethacin, or paracetamol.
What is the purpose of ibuprofen or indomethacin in treating patent ductus arteriosus?
Inhibits prostaglandin synthesis to close the connection.
Who should receive pharmacological treatment for PDA?
The infant, not the mother in the antenatal period.
What is the technique for closure of patent ductus arteriosus in term infants and children?
Transcatheter PDA closure rather than pharmacological therapy.
What are the indications for closure of patent ductus arteriosus in term infants?
Moderate or large PDA, prior episode of endocarditis, small audible PDA.
What role does prostaglandin E1 play in relation to patent ductus arteriosus?
Keeps the duct open until after surgical repair if associated with another congenital heart defect.
True or False: Indomethacin use for PDA is increasing due to its efficacy.
False. Indomethacin use is declining due to increased side-effect profile compared to other drugs.
What is a notable physical examination finding in patent ductus arteriosus?
Left subclavicular thrill.
Fill in the blank: A characteristic of patent ductus arteriosus is a _______ pulse.
Bounding, collapsing
