persistent ductus arteriosus

Description

Paediatrics (Cardio) Mind Map on persistent ductus arteriosus, created by v.djabatey on 28/01/2014.
v.djabatey
Mind Map by v.djabatey, updated more than 1 year ago
v.djabatey
Created by v.djabatey about 10 years ago
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Resource summary

persistent ductus arteriosus
  1. ductus arteriosus connects pulmonary artery to descending aorta
    1. in term infants, normally closes shortly after birth
      1. PDA= ductus arteriosus has failed to close by 1 month after the expected date of delivery
        1. due to defect in constrictor mechanism of the duct
          1. flow of blood across PDA is from aorta to pulmonary artery (L to R)
            1. after fall in pul vasc res after birth
            2. in preterm infant PDA is due to prematurity not congenital heart disease
          2. clinical features
            1. unusual sx
              1. sx of heart failure & pulmonary HTN
                1. if duct large -> increased pulmonary blood flow
              2. signs
                1. continuous murmur beneath L clavicle
                  1. continues into diastole as Aorta Pa > pulmonary a Pa throughout cardiac cycle
                  2. collapsing or bounding pulse
                    1. due to increase in pulse Pa
                2. Ix
                  1. usually normal
                    1. CXR
                      1. ECG
                      2. if PDA large and symptomatic
                        1. features no different to large VSD
                          1. ECG
                            1. left ventricular hypertrophy w/ large L to R shunt
                              1. right ventricular hypertrophy w/ pul HTN
                              2. CXR
                                1. normal/ enlarged heart
                                  1. enlarged pulmonary arteries
                                    1. increased pulmonary vasc
                                  2. echo
                                    1. easily IDs duct
                                2. Mx
                                  1. closure
                                    1. to abolish lifelong risk of
                                      1. bacterial endocarditis
                                        1. pulmonary vasc disease
                                        2. method
                                          1. coil or occlusion device
                                            1. introduced via cardiac catheter at ~ 1yr old
                                            2. surgical ligation
                                        3. a type of left to right shunt
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