Patent Ductus Arteriosus
Basics
Description
Description
- Patent vessel in the fetal heart connects the pulmonary trunk to the descending aorta
- Shortly after birth, changes normally provoke contraction, closure, and fibrosis:
- Sudden increase in the partial pressure of oxygen
- Changes in the synthesis and metabolism of vasoactive eicosanoids
- In the preterm infant, persistent patency of the ductus may be a normal life-saving response
- The patent ductus usually has a normal structural anatomy
- Patency results from hypoxia and immaturity
- In the full-term newborn, patency of the ductus is a congenital malformation
- Deficiency of both the mucoid endothelial layer and the muscular media of the ductus
- As pulmonary vascular resistance falls, aortic blood is shunted into the pulmonary artery
- Extent of the shunt reflects the size of the ductus and the ratio of the pulmonary to systemic vascular resistances
- Up to 70% of the left ventricular output may be shunted through the ductus to the pulmonary circulation
- Risk factors:
- Premature birth
- Coexisting cardiac anomalies
- Conditions resulting in hypoxia
- High altitude
- Maternal rubella infection
- Female-to-male ratio, 3:1
Etiology
Etiology
- Prematurity
- Congenital anomaly
- Hypoxia
- Prostaglandins
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Citation
Schaider, Jeffrey J., et al., editors. "Patent Ductus Arteriosus." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307427/all/Patent_Ductus_Arteriosus.
Patent Ductus Arteriosus. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307427/all/Patent_Ductus_Arteriosus. Accessed December 1, 2024.
Patent Ductus Arteriosus. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307427/all/Patent_Ductus_Arteriosus
Patent Ductus Arteriosus [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 01]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307427/all/Patent_Ductus_Arteriosus.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Patent Ductus Arteriosus
ID - 307427
ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307427/all/Patent_Ductus_Arteriosus
PB - Lippincott Williams & Wilkins
ET - 6
DB - Emergency Central
DP - Unbound Medicine
ER -