Patent ductus arteriosus natural history, complications, and prognosis: Difference between revisions
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*The size of patent ductus arteriosus | *The size of patent ductus arteriosus | ||
*Whether the patient has been treated with closure medicines. | *Whether the patient has been treated with closure medicines. | ||
*Whether surgery has been done. | *Whether [[surgery]] has been done. | ||
*Whether the patient with complications or not, such as heart failure, problems with lung development, or infective endocarditis | *Whether the patient with complications or not, such as [[heart failure]], problems with lung development, or [[infective endocarditis]]. | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 16:26, 22 January 2013
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Patent Ductus Arteriosus Microchapters |
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Differentiating Patent Ductus Arteriosus from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Priyamvada Singh, M.B.B.S. [2], Cafer Zorkun, M.D., Ph.D. [3], Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]
Overview
The natural history of unoperated patients of patent ductus arteriosus depends on the amount of left to right shunting. The left to right shunting in turn depends on the size of ductus and the difference in resistance between the left and right side of heart. PDA can cause complications such as heart failure, infective endocarditis, rhythm disturbance, pulmonary hypertension and Eisenmenger syndrome.
Natural History
Small PDA
- May remain asymptomatic
- Rarely can increase the risk of endarteritis
Moderate PDA
- Left sided heart dysfunction
- Rhythm disturbances like atrial fibrillation as a result of left sided dysfunction
Large PDA
- Left ventricular volume overload
- Increased pulmonary resistance
- Eisenmenger's syndrome
Complications
Heart Failure
- Clinical feature - failure to thrive, feeding difficulties and respiratory distress
- Management involves-
Infective Endocarditis
- Increases risk of septic emboli to lung
- PDA complicated with infective endocarditis is an indication for closure of PDA (ACC/AHA, 2008)
Rhythm Disturbance
- Often associated with atrial fibrillation (left sided dysfunction).
Pulmonary Hypertension
- Right ventricular impulse on palpation
- Pulmonary ejection sound
- A loud single second heart sound
- Graham Steel murmur: The Graham-Steel murmur of pulmonic regurgitation and hypertension. It is high-pitched and "blowing."
Eisenmenger syndrome
Prognosis
Prognosis of patent ductus arteriosus varies widely. It depends on:
- The size of patent ductus arteriosus
- Whether the patient has been treated with closure medicines.
- Whether surgery has been done.
- Whether the patient with complications or not, such as heart failure, problems with lung development, or infective endocarditis.