Patent Ductus Arteriosus and Machinery Murmur
During fetal life, a connection i.e., ductus arteriosus, is made between aorta and pulmonary artery to facilitate blood circulation. However, this connection should be closed in infancy. The persistent connection between aorta and pulmonary artery is abnormal finding and it is referred to as Patent Ductus Arteriosus (PDA). The patient with PDA present with shortness of breath. On examination, tachycardia, bounding pulse, cardiomegaly, and machine-like murmur may be demonstrated. Cyanosis of lower extremities may variably be present. Chest X-ray, echocardiography, and electrocardiography are done to form a diagnosis. Treatment of PDA may be conservative, surgical, or medical. -Conservative Management In patients with asymptomatic PDA, regular outpatient visits are carried out to monitor the condition. -Medical Management NSAIDS, particularly indomethacin and ibuprofen, are administered to close the patent duct by inhibiting the synthesis of prostaglandins. -Surgical Management The patent duct is ligated either manually or with intravascular plugs or coils. Nitinol wire may be used to block the ductus arteriosus. Reference: https://www.youtube.com/watch?v=Fm5xgS1xOOc https://en.wikipedia.org/wiki/Patent_ductus_arteriosus#Signs_and_symptoms
