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A seven year old boy with his father came to Ariana hospital. His chief complaint was shortness of breath ,sweating during playing around with his friends, his father added he has not sufficient weight gain in last months.

On physical exam, machinery mummer heard at the pulmonic level(2nd intercostal left side of sternum).we/DR.Abdul Wahid Siddiqi advise him echocardiography test. Here are his echocardiography findings!

  • Dilated left atria & left ventricle

  • Left to right shunt

  • Mitral regurgitation
  • Pulmonary hypertension
  • Aorto_pulmonic shunt

According to all these findings, he has P.D.A(Patent Ductus Arterioses)

What is PDA?

Fetus circulation system has two arterio-venous shunts at the level of lever(ductus venousus) and the other is between aorta and pulmonary artery trunk(ductus arterioses).

Blood returning from placenta through the umbilical vein reached ductus venousus,Then it enters to right atria from inferior vena cava. High pressure in right atria causes the blood to enter left atria through foramen oval, left atria push this blood to left ventricle ,Then L.V pump it to aorta to supply head and forelimbs.

The blood from superior vena cava enters right atria, through the tricuspid valve to right ventricle, R.V pump it to pulmonary artery. Then it enters aorta through ductus arterioses.

After birth pressure changes in the heart chambers and the lungs are no more collapsed. They cause these shunts normally to close.

In one of thousands the ductus fails to close and results in a patent ductus arterioses, P.D.A results from excessive ductus dilation caused by vasodillating prostaglandins in the ductus walls.

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