Overview
Definition
A congenital heart defect where the ductus arteriosus (connecting the pulmonary artery to the aorta) fails to close after birth.
Epidemiology
More common in premature infants and those born at high altitude. Associated with congenital rubella syndrome.
Etiology & Risk Factors
- Failure of smooth muscle contraction in the ductus due to hypoxia or continued high PGE2 levels
Clinical Symptoms
- Continuous 'machine-like' murmur at left infraclavicular area
- Bounding peripheral pulses
- Wide pulse pressure
- Dyspnea and poor feeding in infants
Clinical Approach
Diagnosis
- Echocardiogram confirming left-to-right shunt flow
Management
- Indomethacin or Ibuprofen (NSAIDs to block prostaglandins and close PDA in preemies)
- Surgical ligation or catheter device closure if symptomatic in term infants/children
Complications
- Heart Failure
- Pulmonary Hypertension (Eisenmenger syndrome)
- Infective Endocarditis