Patent ductus arteriosus — clinical case

Summary of the case

A thriving four-year-old is referred after a continuous machinery murmur is heard at a routine check. On examination there is a continuous crescendo murmur peaking around the second heart sound at the upper left sternal edge, radiating to the back, with a thrill. The peripheral pulses are bounding and collapsing, and the blood pressure shows a widened pulse pressure with a low diastolic. The child is growing normally and has no symptoms. The echocardiogram confirms a moderate patent ductus arteriosus with continuous left-to-right flow, a left atrial to aortic root ratio of 1.6, a high-velocity restrictive flow pattern, and preserved pulmonary pressures. ^[1]