1. Patent ductus arteriosus
An overview

2. DEFINITION
Patent ductus arteriosus (PDA) is a heart problem that is usually noted in the first few weeks or months after birth. It is characterized by a connection between the aorta and the pulmonary artery, which allows oxygen-rich (red) blood that should go to the body to re-circulate through the lungs

3. IN DEPTH

4. IN GROSS

5. HEMODYNAMICS LT TO RT SHUNT OCCURS BOTH DURING SYSTOLE & DIASTOLE
LARGE AMT OF BLOOD PASSES THRU PULM ART-LT ATRIUM –MITRAL VALVE
CONTINOUS MURMUR
ACCENTUATED S1
MITRAL DELAYED DIASTOLIC MURMUR

6. HEMODYNAMICS LARGE FLOW THRU LT VENT-DELAYED CLOSURE OF AORTIC VALVE
DILATATION OF ASCENDING AORTA
LATE A2
PARADOXICALLY SPLIT S2
AORTIC EJECTION CLICK
AORTIC EJECTION SYSTOLIC MURMUR

7. PRESENTATION Frequent chest infections fatigue sweating
rapid breathing
heavy breathing
congested breathing
disinterest in feeding, or tiring while feeding
poor weight gain

8. ON EXAMINATION INSPECTION CAROTID PULSATIONS
HYPERKINETIC & LT VENTRICULAR TYPE OF APICAL IMPULSE
PALPATION
SYSTOLIC OR CONTINOUS THRILL AT 2ND LT INTERSPACE

9. AUSCULTATION ACCENTUATED S1 NARROWLY OR PARADOXICALLY SPLIT S2 LOUD P2
CONTINOUS/GIBSONS/TRAIN-IN-TUNNEL MURMUR BEST HEARD IN INFRACLAVICULAR REGION
MITRAL DELAYED DIASTOLIC MURMUR

10. CXR FINDINGS CARDIOMEGALY LA ENLARGEMENT LV ENLARGEMENT
PROMINENT AORTIC KNUCKLE
PULM PLETHORA

11. ECG CHANGES
NORMAL AXIS WITH LT VENTRICULAR HYPERTROPHY

12. ECHO PICTURES

13. MANAGEMENT
MEDICAL
INDOMETHACIN 0.1 mg/kg/dose,orally,bd for three doses
Digoxin for increasing working capacity of heart
Diuretics to reduce preload on heart

14. SURGICAL REPAIR :DEVICES

15. REPAIR