Patent ductus arteriosus overview: Difference between revisions
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[[Echocardiogram]] is the non-invasive method and can diagnose patent ductus arteriosus. Echo along with [[doppler]] can be used to visualize the [[shunt]] from the [[aorta]] to the [[left pulmonary artery]]. | [[Echocardiogram]] is the non-invasive method and can diagnose patent ductus arteriosus. Echo along with [[doppler]] can be used to visualize the [[shunt]] from the [[aorta]] to the [[left pulmonary artery]]. | ||
===Other Imaging Findings=== | |||
====Cardiac Catheterization==== | |||
[[Cardiac catheterization]] serves to establish the presence of a PDA by assessment of the increase of [[oxygen]] in the [[pulmonary artery]]. It also serves to identify the anatomy of the PDA, the severity of a [[left-to-right shunt]], and the presence of [[pulmonary hypertension]]. | |||
==References== | ==References== | ||
Revision as of 19:57, 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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Diagnosis |
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Patent ductus arteriosus overview On the Web |
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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
Patent Ductus Arteriosus is a remnant of the distal sixth aortic arch and connects the pulmonary artery at the junction of the main pulmonary artery and the origin of the left pulmonary artery to the proximal descending aorta just after the origin of the left subclavian artery.
Patent ductus arteriosus (PDA) is a congenital heart defect when a child's ductus arteriosus fails to close after birth, producing a heart murmur described in 1898 by Gibson as the classic machinery murmur. Normally, the ductus closes within a few hours or days of birth; when it does not, the result is patent ductus arteriosus. This defect is common in premature infants but rare in full-term infants. Symptoms include shortness of breath and cardiac arrhythmia, and may progress to congestive heart failure if left uncorrected.
{{#ev:youtube|5iWbYGkCtCg}}
Anatomy
Patent ductus arteriosus is a heart condition that is normal but reverses soon after birth. In a persistent PDA, there is an irregular transmission of blood between two of the most important arteries (aorta and pulmonary artery) in close proximity to the heart. Although the ductus arteriosus normally seals off within a few days, in PDA, the newborn's ductus arteriosus does not close, but remains patent.
Pathophysiology
The pathophysiological consequences depend on the size of the defect and the pulmonary vascular resistance.[1]
Causes
Causes of Patent ductus arteriosus is not known. However, increased incidence have been associated with mother's rubella and genetic causes
Epidemiology and Demographics
The PDA is commonly found in infants and constitutes only 2% of all congenital defects found in adults. The incidence is greater is in children who are born prematurely with history of perinatal asphyxia and infants with congenital rubella.
Risk Factors
Like many congenital heart disease, the cause of patent ductus arteriosus is not clear. Clinical studies suggest that the genetic and environmental factors both play an important role during the pregnancy.
Natural History, Complications and Prognosis
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 asheart failure, infective endocarditis, rhythm disturbance, pulmonary hypertension and Eisenmenger syndrome.
Diagnosis
Laboratory Findings
Polycythemia may be present if the child has any other congenital heart disease. Hypoxemia or hypercarbia may be present.
Chest X Ray
The findings on chest X ray depends on the degree of shunting between left and right system.
MRI
Magnetic resonance imaging can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive.
CT
Computed tomography can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive.
Echocardiography
Echocardiogram is the non-invasive method and can diagnose patent ductus arteriosus. Echo along with doppler can be used to visualize the shunt from the aorta to the left pulmonary artery.
Other Imaging Findings
Cardiac Catheterization
Cardiac catheterization serves to establish the presence of a PDA by assessment of the increase of oxygen in the pulmonary artery. It also serves to identify the anatomy of the PDA, the severity of a left-to-right shunt, and the presence of pulmonary hypertension.
References
- ↑ Giuliani et al, Cardiology: Fundamentals and Practice, Second Edition, Mosby Year Book, Boston, 1991, pp. 1653-1663.