Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Etiology/Pathophysiology:
The ductus arteriosus (DA) usually closes within 24 hours of birth
and is obliterated anatomically in 1 - 8 weeks. The DA can reopen in
a neonate with hypoxemia or severe pulmonary disease. Initially,
postnatal pulmonary hypertension may prevent a left to right shunt
from developing, but by a week after birth the physiologic decrease
in the patient's pulmonary hypertension may allow a left to right
shunt to develop through the PDA.
Pathology:
Not applicable
Imaging Findings:
Initially the CXR shows the underlying pulmonary disease. As the PDA
opens, the CXR shows a slight increase in heart size and prominence
of central pulmonary vessels which can progress. Pulmonary
interstitial edema leading to some obscuring of vascular sharpness is
usually seen secondary to left heart failure.
An aortogram shows opacification of
pulmonary arteries, veins and right atrium as well as the aorta. The
definite diagnosis is via echocardiogram.
DDX:
Not applicable
References:
See References Chapter.
See related Provider Topics Congenital Heart Disease, Genetics/Birth Defects or Heart and Circulation.
See related Patient Topics Congenital Heart Disease, Genetics/Birth Defects or Heart and Circulation.
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