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Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
The ductus arteriosus (DA) usually closes within 24 hours of birth and is obliterated anatomically in 1 - 8 weeks. The DA can reopen in a neonate with hypoxemia or severe pulmonary disease. Initially, postnatal pulmonary hypertension may prevent a left to right shunt from developing, but by a week after birth the physiologic decrease in the patient's pulmonary hypertension may allow a left to right shunt to develop through the PDA.
Initially the CXR shows the underlying pulmonary disease. As the PDA opens, the CXR shows a slight increase in heart size and prominence of central pulmonary vessels which can progress. Pulmonary interstitial edema leading to some obscuring of vascular sharpness is usually seen secondary to left heart failure. An aortogram shows opacification of pulmonary arteries, veins and right atrium as well as the aorta. The definite diagnosis is via echocardiogram.
See References Chapter.
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