PDA (Patent Ductus Arteriosus): -It is congenital cardiac abnormality that result from failure of closure of the Ductus Arteriosus which cause blood shunting from the left side of the heart to the right side of the heart. -Normally Ductus Arteriosus in the early fetal life is open to allow blood shunting from the aorta to the pulmonary artery due to decreased pressure in the pulmonary artery. -The main risk factors of PDA: 1-Prematurity. 2-Maternal high altitude due to decreased oxygen tension. 3-Maternal rubella infection. 4-Female babies. -The symptoms of PDA: 1-Usually small PDAs are asymptomatic. 2-Moderate to large PDA can produce symptoms of CHF in the 6-8 weeks of life. 3-Patients usually have recurrent lower respiratory tract infections. 4-Patients usually have poor growth. -The signs of PDA: 1-Lower limbs clubbing and edema. 2-Loud S2. 3-Hyper dynamic pericardium. 4-Wide pulse pressure (bounding pulse). 5-Continues machinery murmur best heard in the 2nd left back intercostal space. 6-Large PDAs can produce mid diastolic murmur. -Diagnosis of PDA: 1-CXR can show cardiomegaly. 2-ECG can show LF ventricular enlargement and if the patient have pulmonary hypertension it may also show RT ventricular enlargement. 3-Echo can show LF atrial and ventricular hypertrophy. 4-Colored Doppler flow is diagnostic and it show the blood shunting from the aorta to the pulmonary artery. -Treatment of PDA: 1-Most of small PDAs close spontaneously in the first week of life. 2-Moderate to large PDAs can be managed with Digoxin+Diuretics and endomethacin and if the patients didnt respond to these medications then a surgical correction must be done before the patients is not more than 8 weeks old, this surgical correction is done by either carotid Embolization or closing device.
Posted on: Sun, 14 Jul 2013 12:56:47 +0000
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