Transcript Patent ductus arteriosus - Netmedico | A medico hangout

Patent ductus arteriosus
An overview
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
IN DEPTH
IN GROSS
HEMODYNAMICS
• LT TO RT SHUNT
• CONTINOUS
•
• ACCENTUATED S1
• MITRAL DELAYED
OCCURS BOTH
DURING SYSTOLE &
DIASTOLE
LARGE AMT OF
BLOOD PASSES THRU
PULM ART-LT ATRIUM
–MITRAL VALVE
MURMUR
DIASTOLIC MURMUR
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
PRESENTATION
•
•
•
•
•
•
•
•
Frequent chest infections
fatigue
sweating
rapid breathing
heavy breathing
congested breathing
disinterest in feeding, or tiring while feeding
poor weight gain
ON EXAMINATION
• INSPECTION
• CAROTID
•
PULSATIONS
HYPERKINETIC & LT
VENTRICULAR TYPE
OF APICAL IMPULSE
• PALPATION
• SYSTOLIC OR
CONTINOUS THRILL
AT 2ND LT
INTERSPACE
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
CXR FINDINGS
•
•
•
•
•
CARDIOMEGALY
LA ENLARGEMENT
LV ENLARGEMENT
PROMINENT AORTIC
KNUCKLE
PULM PLETHORA
ECG CHANGES
• NORMAL AXIS WITH LT VENTRICULAR
HYPERTROPHY
ECHO PICTURES
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
SURGICAL REPAIR :DEVICES
REPAIR