Patent ductus arteriosus echocardiography: Difference between revisions
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{{Patent ductus arteriosus}} | {{Patent ductus arteriosus}} | ||
{{CMG}}; '''Associate Editor-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto: | {{CMG}}; '''Associate Editor-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com], {{CZ}}, {{RG}}'''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu] | ||
==Overview== | ==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== | |||
== | * 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> | ||
In the adult, doppler can be used to visualize the shunt from the aorta to the left pulmonary artery. | * [[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> | ||
*[[Suprasternal notch|Suprasternal]] view | |||
* High parasternal short-axis view: aim probe leftward/superior | |||
*[[Transesophageal echocardiogram]] (often needed in adults to accurately visualize a [[Patent ductus arteriosus|PDA]]) | |||
==== Functions ==== | |||
* 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]]. | |||
* Calculation of the peak pressure gradient in the [[Patent ductus arteriosus|PDA]] can be calculated with the modified [[Bernoulli equation|Bernoulli]] equation. | |||
* Associated anomalies. | |||
[[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>]] | |||
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==References== | ==References== | ||
{{reflist}} | {{reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Disease | [[Category:Disease]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Congenital heart disease]] | [[Category:Congenital heart disease]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
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
- The PDA can usually be visualized on two-dimensional echocardiography, showing left atrial (LA) and left ventricular (LV) enlargement.[1][2][3]
- 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 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. [4]
PDAs can be seen on:[5]
- Suprasternal view
- High parasternal short-axis view: aim probe leftward/superior
- Transesophageal echocardiogram (often needed in adults to accurately visualize a PDA)
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.
_in_Transesophageal_echocardiography.jpg)
References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ "A rare presentation of patent ductus arteriosus in an adult patient with normal pulmonary hypertension and limb edema".