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Patent Ductus Arteriosus

Patent Ductus Arteriosus is a topic covered in the 5-Minute Emergency Consult.

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  • 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


  • Prematurity
  • Congenital anomaly
  • Hypoxia
  • Prostaglandins

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Rosen, Peter, et al., editors. "Patent Ductus Arteriosus." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307427/all/Patent_Ductus_Arteriosus.
Patent Ductus Arteriosus. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307427/all/Patent_Ductus_Arteriosus. Accessed April 22, 2019.
Patent Ductus Arteriosus. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307427/all/Patent_Ductus_Arteriosus
Patent Ductus Arteriosus [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 22]. 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 - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, 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 - 5 DB - Emergency Central DP - Unbound Medicine ER -