Patent ductus arteriosus - Revision history

Danbot: Add MedicationDose entry for indomethacin

2026-03-20T21:10:32Z

Add MedicationDose entry for indomethacin

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 *Stable, asymptomatic patients can be discharged home with cardiology follow-up
 *Symptomatic patients and patients requiring treatment should be admitted with cardiology consultation
 ==See Also==

Rossdonaldson1: /* Clinical Features */

2024-11-13T16:33:27Z

Clinical Features

← Older revision		Revision as of 16:33, 13 November 2024
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	==Clinical Features==		==Clinical Features==
			[[File:Phonocardiograms from normal and abnormal heart sounds.svg\|thumb\|Phonocardiograms of common cardiac murmurs.]]
	* Continuous machine like heart [[murmur]]		* Continuous machine like heart [[murmur]]
	* Differential cyanosis (cyanosis of lower extremities and not the upper extremities)		* Differential cyanosis (cyanosis of lower extremities and not the upper extremities)

Rossdonaldson1: /* Evaluation */

2024-11-13T16:22:01Z

Evaluation

← Older revision		Revision as of 16:22, 13 November 2024
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	==Evaluation==		==Evaluation==
	~~[[File:Verschluss Ductus arteriosus Botalli mit Clips 60W - CR und CT - 001 - Annotation.jpg\|thumb\|Chest x-ray and CT showing clips visible for past treatment of patent ductus arteriosus.]]~~
	[[File:Stent tekst.jpg\|thumb\|[[Echocardiogram]] of a stented persisting ductus arteriosus. The aortic arch and the stent leaving it are seen. The pulmonary artery is not visable.]]		[[File:Stent tekst.jpg\|thumb\|[[Echocardiogram]] of a stented persisting ductus arteriosus. The aortic arch and the stent leaving it are seen. The pulmonary artery is not visable.]]
	[[File:PDA Fomani.gif\|thumbnail\|Echocardiography demonstrating PDA<ref>http://www.thepocusatlas.com/pediatrics/</ref>]]		[[File:PDA Fomani.gif\|thumbnail\|Echocardiography demonstrating PDA<ref>http://www.thepocusatlas.com/pediatrics/</ref>]]
	* Careful physical examination demonstrating characteristic machine like murmur		[[File:Verschluss Ductus arteriosus Botalli mit Clips 60W - CR und CT - 001 - Annotation.jpg\|thumb\|Chest x-ray and CT showing clips visible from past treatment of patent ductus arteriosus.]]
			* Careful physical examination demonstrating characteristic machine-like murmur
	* [[Echocardiography]]		* [[Echocardiography]]
	**MRA and Cardiac CT can also be used as diagnostic tools		**MRA and Cardiac CT can also be used as diagnostic tools

Rossdonaldson1: /* Evaluation */

2024-11-13T16:20:52Z

Evaluation

← Older revision		Revision as of 16:20, 13 November 2024
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	==Evaluation==		==Evaluation==
	[[File:Verschluss Ductus arteriosus Botalli mit Clips 60W - CR und CT - 001 - Annotation.jpg\|thumb]]		[[File:Verschluss Ductus arteriosus Botalli mit Clips 60W - CR und CT - 001 - Annotation.jpg\|thumb\|Chest x-ray and CT showing clips visible for past treatment of patent ductus arteriosus.]]
	[[File:Stent tekst.jpg\|thumb\|[[Echocardiogram]] of a stented persisting ductus arteriosus. The aortic arch and the stent leaving it are seen. The pulmonary artery is not visable.]]		[[File:Stent tekst.jpg\|thumb\|[[Echocardiogram]] of a stented persisting ductus arteriosus. The aortic arch and the stent leaving it are seen. The pulmonary artery is not visable.]]
	[[File:PDA Fomani.gif\|thumbnail\|Echocardiography demonstrating PDA<ref>http://www.thepocusatlas.com/pediatrics/</ref>]]		[[File:PDA Fomani.gif\|thumbnail\|Echocardiography demonstrating PDA<ref>http://www.thepocusatlas.com/pediatrics/</ref>]]

Rossdonaldson1: /* Evaluation */

2024-11-13T16:19:09Z

Evaluation

← Older revision		Revision as of 16:19, 13 November 2024
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	==Evaluation==		==Evaluation==
			[[File:Verschluss Ductus arteriosus Botalli mit Clips 60W - CR und CT - 001 - Annotation.jpg\|thumb]]
	[[File:Stent tekst.jpg\|thumb\|[[Echocardiogram]] of a stented persisting ductus arteriosus. The aortic arch and the stent leaving it are seen. The pulmonary artery is not visable.]]		[[File:Stent tekst.jpg\|thumb\|[[Echocardiogram]] of a stented persisting ductus arteriosus. The aortic arch and the stent leaving it are seen. The pulmonary artery is not visable.]]
	[[File:PDA Fomani.gif\|thumbnail\|Echocardiography demonstrating PDA<ref>http://www.thepocusatlas.com/pediatrics/</ref>]]		[[File:PDA Fomani.gif\|thumbnail\|Echocardiography demonstrating PDA<ref>http://www.thepocusatlas.com/pediatrics/</ref>]]

Rossdonaldson1: /* Evaluation */

2024-11-13T16:11:39Z

Evaluation

← Older revision		Revision as of 16:11, 13 November 2024
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	==Evaluation==		==Evaluation==
	[[File:Stent tekst.jpg\|thumb\|[[[[Echocardiogram]] of a stented persisting ductus arteriosus. The aortic arch and the stent leaving it are seen. The pulmonary artery is not visable.]]		[[File:Stent tekst.jpg\|thumb\|[[Echocardiogram]] of a stented persisting ductus arteriosus. The aortic arch and the stent leaving it are seen. The pulmonary artery is not visable.]]
	[[File:PDA Fomani.gif\|thumbnail\|Echocardiography demonstrating PDA<ref>http://www.thepocusatlas.com/pediatrics/</ref>]]		[[File:PDA Fomani.gif\|thumbnail\|Echocardiography demonstrating PDA<ref>http://www.thepocusatlas.com/pediatrics/</ref>]]
	* Careful physical examination demonstrating characteristic machine like murmur		* Careful physical examination demonstrating characteristic machine like murmur

Rossdonaldson1: /* Background */

2024-11-13T16:10:29Z

Background

← Older revision		Revision as of 16:10, 13 November 2024
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	==Background==		==Background==
			[[File:PDA.png\|thumb\|Patent ductus arteriosus in a heart after birth.]]
			[[File:Gray502.png\|thumb\|The fetal circulatory system showing with the normally open ductus arteriosus prior to birth (visible in upper right).]]
	*Ductus arteriosus is a blood vessel connecting main pulmonary artery to proximal descending aorta		*Ductus arteriosus is a blood vessel connecting main pulmonary artery to proximal descending aorta
	**Shunts blood from right ventricle to bypass fetus's non-functioning lungs in utero		**Shunts blood from right ventricle to bypass fetus's non-functioning lungs in utero
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	===Pathophysiology===		===Pathophysiology===
	~~[[File:PDA.png\|thumb]]~~
	*Ductus arteriosus shunts blood from the pulmonary artery to the aorta bypassing the lungs while in utero		*Ductus arteriosus shunts blood from the pulmonary artery to the aorta bypassing the lungs while in utero
	*Normally closes soon after birth via complex process		*Normally closes soon after birth via complex process

Rossdonaldson1: /* Evaluation */

2024-11-06T19:12:11Z

Evaluation

← Older revision		Revision as of 19:12, 6 November 2024
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	==Evaluation==		==Evaluation==
			[[File:Stent tekst.jpg\|thumb\|[[[[Echocardiogram]] of a stented persisting ductus arteriosus. The aortic arch and the stent leaving it are seen. The pulmonary artery is not visable.]]
	[[File:PDA Fomani.gif\|thumbnail\|Echocardiography demonstrating PDA<ref>http://www.thepocusatlas.com/pediatrics/</ref>]]		[[File:PDA Fomani.gif\|thumbnail\|Echocardiography demonstrating PDA<ref>http://www.thepocusatlas.com/pediatrics/</ref>]]
	* Careful physical examination demonstrating characteristic machine like murmur		* Careful physical examination demonstrating characteristic machine like murmur

ClaireLewis at 15:10, 12 September 2019

2019-09-12T15:10:45Z

← Older revision		Revision as of 15:10, 12 September 2019
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	* [[Tachycardia]]		* [[Tachycardia]]
	* Widened pulse pressure		* Widened pulse pressure
	* Congestive heart failure		* [[Congestive heart failure]]
	* Failure to thrive		* [[Failure to thrive (peds)\|Failure to thrive]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	* Aortopulmonary Septal Defect		* Aortopulmonary Septal Defect
	* [[Coarctation of the Aorta]]		* [[Coarctation of the Aorta]]
	* Coronary ~~Artery Fistula~~		* [[Anomalous coronary arteries\|Coronary artery fistula]]
	* Pediatric ~~Acute Respiratory Distress Syndrome~~		* Pediatric acute [[respiratory distress syndrome]]
	* ~~Pediatric~~ Sinus of ~~Valsalva Aneurysm~~		* Sinus of valsalva aneurysm
	* Pediatric ~~Tachycardia~~		* Pediatric [[tachycardia]]
	* Pulmonic ~~Valvular Stenosis~~		* Pulmonic valvular stenosis
	* [[Sickle cell anemia]]		* [[Sickle cell anemia]]
	* Tetralogy of Fallot ~~With Absent Pulmonary Valve~~		* [[Tetralogy of Fallot]] with absent pulmonary valve

	{{Congenital heart disease DDX}}		{{Congenital heart disease DDX}}
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	==Management==		==Management==
	*Spontaneous closure common		*Spontaneous closure common
	*If significant respiratory distress or impaired oxygen delivery, therapy usually required		*If significant [[shortness of breath (peds)\|respiratory distress]] or impaired oxygen delivery, therapy usually required

	=== Medical Therapy ===		=== Medical Therapy ===
	*IV [[indomethacin]]: usually effective when administered in the first 10-14 days of life.		*IV [[indomethacin]]: usually effective when administered in the first 10-14 days of life.
			**<48 hour old: start 0.2mg/kg IV x 1, then 0.1mg/kg q12-24h x 2
			**2-7 days old: Start 0.2mg/kg IV x 1, then 0.2mg/kg q12-24h x 2
			**> 7 days old: Start 0.2mg/kg IV x 1, then 0.25mg/kg q12-24h x 2

	=== Surgical Therapy ===		=== Surgical Therapy ===

SLuckettG: /* Disposition */

2019-03-09T14:45:04Z

Disposition

← Older revision		Revision as of 14:45, 9 March 2019
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	==Disposition==		==Disposition==
			*Stable, asymptomatic patients can be discharged home with cardiology follow-up
			*Symptomatic patients and patients requiring treatment should be admitted with cardiology consultation

	==See Also==		==See Also==