PDA Quiz: Patent Ductus Arteriosus Flashcards

Study Notes

Patent Ductus Arteriosus (PDA)

Failure of the fetal ductus arteriosus to close within the first weeks of life, allowing blood to flow from the aorta to the pulmonary artery
Causes a left-to-right shunt, which can lead to heart failure (HF), infective endocarditis, and pulmonary vascular obstructive disease
Clinical manifestations: asymptomatic or widened pulse pressure, risk of HF
Medical treatment: administration of indomethacin (prostaglandin inhibitor) to close the PDA
Nonsurgical treatment: coils to occlude PDA placed in a catheterization laboratory
Surgical treatment: may be necessary for some patients

Coarctation of the Aorta (COA)

Localized narrowing near the insertion of ductus arteriosus
Causes increased pressure proximal to the defect and decreased pressure distal to the obstruction
Symptoms: high blood pressure in the upper arms, bounding pulses in the arms, weak or absent femoral pulses, cool lower extremities with lower blood pressure
Signs of heart failure (HF) in infants, dizziness, headaches, fainting, epistaxis in older children
Treatment: surgical repair is the treatment of choice for infants younger than 6 months, balloon angioplasty is the primary intervention for older children

Tetralogy of Fallot (TOF)

Ventricular septal defect (VSD), pulmonic stenosis, right ventricular hypertrophy, and overriding aorta
Clinical manifestations: some infants may be acutely cyanotic at birth, while others have mild cyanosis that progresses over the first year of life
Signs and symptoms: acute episodes of cyanosis and hypoxia (blue spells or tet spells), risk of emboli, seizures, loss of consciousness, or sudden death
Treatment: calming the baby and holding the baby in the knee-chest position to break the cycle, palliative treatment includes shunt or complete repair in the first year of life

Transposition of the Great Vessels (TGV or TPGA)

The two great vessels of the aorta and pulmonary artery are reversed, resulting in cyanotic blood flowing to the brain
Results in two separate circulatory systems—systemic and pulmonary
Assessment and symptoms: poor feeding, profound cyanosis, tachypnea, signs and symptoms of CHF, chest x-ray “egg on a string” visualization
Therapeutic management: providing intra-cardiac mixing, administration of intravenous prostaglandin E1 to keep the ductus arteriosus open, balloon atrial septostomy (Rashkind procedure) to increase mixing

Description

Learn about Patent Ductus Arteriosus (PDA), a condition where the fetal ductus arteriosus fails to close after birth, leading to a left-to-right shunt. Understand the clinical manifestations, including symptoms of heart failure, widened pulse pressure, and associated risks.