Patent Ductus Arteriosus

 

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A patent ductus arteriosus (PDA) is a remnant communication between the aorta and pulmonary artery that has failed to close after birth. It is typically seen first during color Doppler examination as a flow with abnormal origin along the pulmonary artery. The flow is present in both systole and diastole (continuous) given aortic pressures are higher than PA pressures in both systole and diastole. This PDA was detected first on color Doppler in the parasternal long axis, RV outflow view shown to the left here.

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The parasternal short axis, however, is the best view to lay out the PDA. Shown to the left with color Doppler, a color jet (present in both systole and diastole, but more prominent in systole) is seen originating from the left proximal pulmonary artery (the common location for a PDA). This individual also has physiologic pulmonary regurgitation (this jet is only in diastole, near the top of the color window and useful for a comparison)

 

 

When PW and CW Doppler are placed through the flow we can see that it is indeed continuous. .

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Sometimes the PDA flow is also seen in the far field of a suprasternal notch view. This is another reason it is important to perform color Doppler down along the descending aorta in this view.

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Finally, here is a comparison of the best view to see a PDA, the parasternal short axis, with and without the color window. Make sure to keep a lookout for these. The are more common than you may think in the asymptomatic individual.