When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Patent ductus arteriosus

Last reviewed: 17 Aug 2025
Last updated: 23 Apr 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presentation in infancy
Full details

Other diagnostic factors

  • tachypnea/shortness of breath (SOB)
  • faltering growth
  • exercise intolerance
  • widened pulse pressure
  • machine-like continuous murmur/Gibson murmur in children born at full-term
  • apnea
  • low diastolic blood pressure (BP)
  • irritability
  • diaphoresis
  • increased respiratory symptoms with upper respiratory infection
  • murmur heard only during systole
  • hyperdynamic precordium
  • systolic thrill
  • third heart sound heard at apex
  • mid-diastolic rumble heard at apex
  • bounding peripheral pulses
  • pulmonary rales
Detalhes completos

Fatores de risco

  • prematurity
  • maternal rubella
  • female sex
  • respiratory distress syndrome (RDS)
  • high altitude
  • family history
  • black race
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • CXR
  • ECG
  • echocardiogram
Detalhes completos

Investigações a serem consideradas

  • cardiac catheterization and angiography
Detalhes completos

Algoritmo de tratamento

Inicial

premature very low birth weight infants: prophylactic therapy

AGUDA

premature infants (<32 weeks)

term infants and children: small-to-moderate-sized ducts

term infants and children: large ducts and/or symptomatic infants too small for device closure

adults

Colaboradores

Autores

Kenneth M. Coca, MD​

Pediatric Cardiology Fellow

Johns Hopkins All Children’s Hospital

Saint Petersburg

FL

Declarações

KMC declares that he has no competing interests.

Joyce T. Johnson, MD, MS

Director, Fetal Cardiology

Johns Hopkins All Children’s Hospital

Saint Petersburg

FL

Declarações

JTJ declares that she has no competing interests.

Agradecimentos

Dr Kenneth M. Coca and Dr Joyce T. Johnson would like to gratefully acknowledge Dr Anji T. Yetman and Dr Nelangi M. Pinto, previous contributors to this topic.

Declarações

ATY declares that she has no competing interests.

Revisores

Michael Cheung, BSc (Hons), MB ChB, MRCP, FRACP

Acting Head

Department of Cardiology

Royal Children's Hospital

Melbourne

Australia

Раскрытие информации

MC declares that he has no competing interests.

Rajat Bhatt, MD

Assistant Professor

Internal Medicine

Texas Tech University Health Sciences Center (TTUHSC)

Lubbock

TX

Раскрытие информации

RB declares that he has no competing interests.

Henry M. Sondheimer, MD

Professor of Pediatrics

Clinical Director

Pediatric Cardiology

The Children's Hospital

Denver

CO

Раскрытие информации

HMS declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Baumgartner H, De Backer J, Babu-Narayan SV, et al. 2020 ESC guidelines for the management of adult congenital heart disease. Eur Heart J. 2021 Feb 11;42(6):563-645.Полный текст

Hamrick SEG, Sallmon H, Rose AT, et al. Patent ductus arteriosus of the preterm infant. Pediatrics. 2020 Nov;146(5):e20201209.Полный текст  Аннотация

Wilson WR, Gewitz M, Lockhart PB, et al. Prevention of viridans group streptococcal infective endocarditis: a scientific statement from the American Heart Association. Circulation. 2021 May 18;143(20):e963-78.Полный текст  Аннотация

Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC guideline for the management of adults with congenital heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019 Apr 2;73(12):1494-563.Полный текст  Аннотация

John AS, Jackson JL, Moons P, et al. Advances in managing transition to adulthood for adolescents with congenital heart disease: a practical approach to transition program design: a scientific statement from the American Heart Association. J Am Heart Assoc. 2022 Apr 5;11(7):e025278.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Использование этого контента попадает под действие нашего заявления об отказе от ответственности