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Patent Ductus Arteriosus

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Learning Cardiac Auscultation

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Abstract

Patent ductus arteriosus (PDA) is a congenital heart defect where the ductus arteriosus maintains a shunt between the left pulmonary artery and the aorta. Clinical presentation and findings on cardiac auscultation vary depending on the size of the shunt. Classically, PDA presents with a continuous crescendo-decrescendo murmur described as “machinery-like”. To determine the degree of shunting through the PDA, Doppler echocardiography may be employed. Patients with a large PDA are at risk for persistent elevation in pulmonary vascular resistance thereby precipitating Eisenmenger’s syndrome. In this syndrome, shunting is ultimately reversed and patients experience subsequent cyanosis and/or pulmonary hypertension. The decision to treat a PDA should be based upon a combination of clinical signs and echocardiographic parameters. Treatment options include pharmacological closure in infants, catheterization, and surgical ligation.

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Author information

Authors and Affiliations

  1. Georgetown University School of Medicine, Georgetown University Hospital, Washington, DC, USA

    Brynn Connor BS, MD, Victoria Eng BS, MD, Meghan C. Kusko BA, MD & Kathryn Maselli BS, MD

Authors
  1. Brynn Connor BS, MD
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  2. Victoria Eng BS, MD
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  3. Meghan C. Kusko BA, MD
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  4. Kathryn Maselli BS, MD
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Corresponding author

Correspondence to Brynn Connor BS, MD .

Editor information

Editors and Affiliations

  1. Medstar Georgetown University Hospital, Washington, District of Columbia, USA

    Allen J. Taylor

1 Electronic Supplementary Material

Video 26.1

PDA with a long diastolic component, which makes the murmur truly continuous (Provided by Robin Winkler Doroshow, MD, Medstar Georgetown University Hospital, Washington, DC) (MP4 954 kb)

Video 26.2

PDA with a short diastolic component that is more typical (Provided by Robin Winkler Doroshow, MD, Medstar Georgetown University Hospital, Washington, DC) (MP4 1354 kb)

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© 2015 Springer-Verlag London

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Connor, B., Eng, V., Kusko, M.C., Maselli, K. (2015). Patent Ductus Arteriosus. In: Taylor, A. (eds) Learning Cardiac Auscultation. Springer, London. https://doi.org/10.1007/978-1-4471-6738-9_26

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  • DOI: https://doi.org/10.1007/978-1-4471-6738-9_26

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6737-2

  • Online ISBN: 978-1-4471-6738-9

  • eBook Packages: MedicineMedicine (R0)

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