Patent ductus arteriosus echocardiography: Difference between revisions

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[[Echocardiogram]] is the non-invasive method and can diagnose patent ductus arteriosus. Echo along with [[doppler]] can be used to visualize the [[shunt]] from the [[aorta]] to the [[left pulmonary artery]].
[[Echocardiogram]] is the non-invasive method and can diagnose patent ductus arteriosus. Echo along with [[doppler]] can be used to visualize the [[shunt]] from the [[aorta]] to the [[left pulmonary artery]].
==Echocardiography==
==Echocardiography==
The PDA can usually be visualized on [[two-dimensional echocardiography]], showing [[Left atrial enlargement|left atrial]] (LA) and left ventricular (LV) enlargement. It can also be assessed by [[doppler]] and color flow imaging, establishing the diagnosis and distension of a small nonpulmonary hypertensive ductus from a coronary arteriovenous fistula to the [[pulmonary artery]].  [[Doppler]] shows the presence of a continuous flow into the left PA and main [[PA]] trunk. The maximum acceleration of the [[blood flow]] is in late [[systole]] and early [[diastole]].
 
In the adult, [[doppler]] can be used to visualize the [[shunt]] from the [[aorta]] to the [[left pulmonary artery]]. <ref name="SinhaDalal2013">{{cite journal|last1=Sinha|first1=Rahul|last2=Dalal|first2=SS|last3=Negi|first3=Vandana|title=An interesting observation of PDA closure with oral paracetamol in preterm neonates|journal=Journal of Clinical Neonatology|volume=2|issue=1|year=2013|pages=30|issn=2249-4847|doi=10.4103/2249-4847.109245}}</ref>
* The [[Patent ductus arteriosus|PDA]] can usually be visualized on [[two-dimensional echocardiography]], showing [[Left atrial enlargement|left atrial]] ([[Left atrium|LA]]) and left ventricular ([[Left ventricle|LV]]) enlargement.<ref name="pmid7411301">{{cite journal| author=Serwer GA, Armstrong BE, Anderson PA| title=Nonivasive detection of retrograde descending aortic flow in infants using continuous wave doppler ultrasonography. Implications for diagnosis of aortic run-off lesions. | journal=J Pediatr | year= 1980 | volume= 97 | issue= 3 | pages= 394-400 | pmid=7411301 | doi=10.1016/s0022-3476(80)80188-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7411301  }}</ref><ref name="pmid3962872">{{cite journal| author=Cloez JL, Isaaz K, Pernot C| title=Pulsed Doppler flow characteristics of ductus arteriosus in infants with associated congenital anomalies of the heart or great arteries. | journal=Am J Cardiol | year= 1986 | volume= 57 | issue= 10 | pages= 845-51 | pmid=3962872 | doi=10.1016/0002-9149(86)90625-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3962872  }}</ref><ref name="pmid3568325">{{cite journal| author=Hiraishi S, Horiguchi Y, Misawa H, Oguchi K, Kadoi N, Fujino N | display-authors=etal| title=Noninvasive Doppler echocardiographic evaluation of shunt flow dynamics of the ductus arteriosus. | journal=Circulation | year= 1987 | volume= 75 | issue= 6 | pages= 1146-53 | pmid=3568325 | doi=10.1161/01.cir.75.6.1146 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3568325  }}</ref>
* [[Patent ductus arteriosus|PDA]] can also be assessed by [[doppler]] and color flow imaging, establishing the [[diagnosis]] and distension of a small nonpulmonary [[hypertensive]] ductus from a [[Coronary Artery Fistula|coronary]] arteriovenous fistula to the [[pulmonary artery]].   
* [[Doppler]] shows the presence of a continuous flow into the left PA and main [[PA]] trunk.  
* The maximum acceleration of the [[blood flow]] is in late [[systole]] and early [[diastole]].
* In the adult, [[doppler]] can be used to visualize the [[shunt]] from the [[aorta]] to the [[left pulmonary artery]]. <ref name="SinhaDalal2013">{{cite journal|last1=Sinha|first1=Rahul|last2=Dalal|first2=SS|last3=Negi|first3=Vandana|title=An interesting observation of PDA closure with oral paracetamol in preterm neonates|journal=Journal of Clinical Neonatology|volume=2|issue=1|year=2013|pages=30|issn=2249-4847|doi=10.4103/2249-4847.109245}}</ref>


PDAs can be seen on:<ref name="JainShah2015">{{cite journal|last1=Jain|first1=Amish|last2=Shah|first2=Prakesh S.|title=Diagnosis, Evaluation, and Management of Patent Ductus Arteriosus in Preterm Neonates|journal=JAMA Pediatrics|volume=169|issue=9|year=2015|pages=863|issn=2168-6203|doi=10.1001/jamapediatrics.2015.0987}}</ref>
PDAs can be seen on:<ref name="JainShah2015">{{cite journal|last1=Jain|first1=Amish|last2=Shah|first2=Prakesh S.|title=Diagnosis, Evaluation, and Management of Patent Ductus Arteriosus in Preterm Neonates|journal=JAMA Pediatrics|volume=169|issue=9|year=2015|pages=863|issn=2168-6203|doi=10.1001/jamapediatrics.2015.0987}}</ref>


* Suprasternal view
*[[Suprasternal notch|Suprasternal]] view
* High parasternal short-axis view: aim probe leftward/superior
* High parasternal short-axis view: aim probe leftward/superior
* [[Transesophageal echocardiogram]] (often needed in adults to accurately visualize a PDA)
*[[Transesophageal echocardiogram]] (often needed in adults to accurately visualize a [[Patent ductus arteriosus|PDA]])


==== Functions<ref name="Abu-SulaimanSubaih2004">{{cite journal|last1=Abu-Sulaiman|first1=R. M.|last2=Subaih|first2=B.|title=Congenital Heart Disease in Infants of Diabetic Mothers: Echocardiographic Study|journal=Pediatric Cardiology|volume=25|issue=2|year=2004|pages=137–140|issn=0172-0643|doi=10.1007/s00246-003-0538-8}}</ref> ====
==== Functions ====


* Estimate the magnitude of the [[shunt]].
* Estimate the magnitude of the [[shunt]].<ref name="Abu-SulaimanSubaih2004">{{cite journal|last1=Abu-Sulaiman|first1=R. M.|last2=Subaih|first2=B.|title=Congenital Heart Disease in Infants of Diabetic Mothers: Echocardiographic Study|journal=Pediatric Cardiology|volume=25|issue=2|year=2004|pages=137–140|issn=0172-0643|doi=10.1007/s00246-003-0538-8}}</ref>
* Degree of left ventricular and [[left atrial dilation]].
* Degree of left ventricular and [[left atrial dilation]].
* Calculation of the peak pressure gradient in the PDA can be calculated with the modified Bernoulli equation.
* Calculation of the peak pressure gradient in the [[Patent ductus arteriosus|PDA]] can be calculated with the modified [[Bernoulli equation|Bernoulli]] equation.
* Associated anomalies
* Associated anomalies.
[[Image:PDA.jpg|thumb]]
----
Shown below is an echocardiogram of a stented persisting ductus arteriosus. One can see the [[aortic arch]] and the stent leaving.
----
Shown below is an echocardiogram of a coiled persisting ductus arteriosus. One can see the [[aortic arch]], the [[pulmonary artery]] and the coil between them.
[[Image:PDA_Coil.png.png|center|500px|An echocardiogram of a coiled persisting ductus arteriosus. One can see the aortic arch, the pulmonary artery and the coil between them.]]


[[File:Patent ductus arteriosus (PDA) in Transesophageal echocardiography.jpg|alt=PDA (diameter = 6-7 mm)|center|thumb|248x248px|Echocardiogram showed; normal left ventricular chamber size and function, normal size of both atria. Furthermore, an obvious PDA (diameter = 6-7 mm) connecting the proximal of descending aorta to the left to the pulmonary artery was reported in echocardiography.Case courtesy by Bahram Pishgoo et al<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251482/|title=A rare presentation of patent ductus arteriosus in an adult patient with normal pulmonary hypertension and limb edema|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>]]
<br />
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 17:57, 13 March 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Priyamvada Singh, M.B.B.S. [2], Cafer Zorkun, M.D., Ph.D. [3], Ramyar Ghandriz MD[4]Assistant Editor-In-Chief: Kristin Feeney, B.S. [5]

Overview

Echocardiogram is the non-invasive method and can diagnose patent ductus arteriosus. Echo along with doppler can be used to visualize the shunt from the aorta to the left pulmonary artery.

Echocardiography

PDAs can be seen on:[5]

Functions

  • Estimate the magnitude of the shunt.[6]
  • Degree of left ventricular and left atrial dilation.
  • Calculation of the peak pressure gradient in the PDA can be calculated with the modified Bernoulli equation.
  • Associated anomalies.
PDA (diameter = 6-7 mm)
Echocardiogram showed; normal left ventricular chamber size and function, normal size of both atria. Furthermore, an obvious PDA (diameter = 6-7 mm) connecting the proximal of descending aorta to the left to the pulmonary artery was reported in echocardiography.Case courtesy by Bahram Pishgoo et al[7]


References

  1. ↑ Serwer GA, Armstrong BE, Anderson PA (1980). "Nonivasive detection of retrograde descending aortic flow in infants using continuous wave doppler ultrasonography. Implications for diagnosis of aortic run-off lesions". J Pediatr. 97 (3): 394–400. doi:10.1016/s0022-3476(80)80188-0. PMID 7411301.
  2. ↑ Cloez JL, Isaaz K, Pernot C (1986). "Pulsed Doppler flow characteristics of ductus arteriosus in infants with associated congenital anomalies of the heart or great arteries". Am J Cardiol. 57 (10): 845–51. doi:10.1016/0002-9149(86)90625-9. PMID 3962872.
  3. ↑ Hiraishi S, Horiguchi Y, Misawa H, Oguchi K, Kadoi N, Fujino N; et al. (1987). "Noninvasive Doppler echocardiographic evaluation of shunt flow dynamics of the ductus arteriosus". Circulation. 75 (6): 1146–53. doi:10.1161/01.cir.75.6.1146. PMID 3568325.
  4. ↑ Sinha, Rahul; Dalal, SS; Negi, Vandana (2013). "An interesting observation of PDA closure with oral paracetamol in preterm neonates". Journal of Clinical Neonatology. 2 (1): 30. doi:10.4103/2249-4847.109245. ISSN 2249-4847.
  5. ↑ Jain, Amish; Shah, Prakesh S. (2015). "Diagnosis, Evaluation, and Management of Patent Ductus Arteriosus in Preterm Neonates". JAMA Pediatrics. 169 (9): 863. doi:10.1001/jamapediatrics.2015.0987. ISSN 2168-6203.
  6. ↑ Abu-Sulaiman, R. M.; Subaih, B. (2004). "Congenital Heart Disease in Infants of Diabetic Mothers: Echocardiographic Study". Pediatric Cardiology. 25 (2): 137–140. doi:10.1007/s00246-003-0538-8. ISSN 0172-0643.
  7. ↑ "A rare presentation of patent ductus arteriosus in an adult patient with normal pulmonary hypertension and limb edema".

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