Patent Ductus Arteriosus (PDA)
Persistent fetal shunt between aorta and pulmonary artery. Hemodynamic significance depends on size, direction, and systemic perfusion.
All references
Key points
- Widening pulse pressure, bounding pulses, hyperactive precordium.
- Echo: ductal diameter >1.5 mm, LA:Ao >1.4, reversed/absent diastolic flow in descending aorta.
- Treatment: conservative fluid restriction, indomethacin, ibuprofen, or acetaminophen; surgical/transcatheter closure if persistent and symptomatic.
Pitfalls
- Not all PDAs need treatment — focus on hemodynamic significance.
- Indomethacin contraindicated in renal dysfunction, NEC, active bleeding.
Ask the Copilot
- — When should I treat a PDA?
- — Walk me through hsPDA echo criteria.