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Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Patent ductus arteriosus (PDA) is most common in premature infants. The most common congenital heart defects are ventricular and atrial septal defects. Patent ductus arteriosus can be asymptomatic if small, but if large they present with signs of heart failure due to the left to right shunt. PDA is an acyanotic congenital cardiac anomaly and children may have signs of cardiomegaly and pulmonary oedema.
DRCOG MCQs for Circuit C Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Prematurity is associated with:Increased risk of necrotizing enterocolitis.Hyaline membrane disease.Intraventricular haemorrhage.Persistent patent ductus arteriosus.Kernicterus.
Common cardiac conditions, drugs and methods of assessment
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
Patent ductus arteriosus has usually been treated during childhood. If they are large and are not repaired, by adulthood there is a likelihood of Eisenmenger’s syndrome and fetal loss. Surgery is possible during pregnancy. If unrepaired, close monitoring of the pregnancy will be offered and antibiotics are necessary as a prophylactic.
Congenital heart disease: addressing the need for novel lower-risk percutaneous interventional strategies
Published in Expert Review of Cardiovascular Therapy, 2023
N Linnane, DP Kenny, ZM Hijazi
Multiple studies have demonstrated that younger patients (<1 month) at catheterization is an independent risk factor for a serious adverse event during catheterization [9,18,19,21,22,41]. However, this is also likely influenced by comorbidities and the complexity of the intervention. Gestational age may be more relevant than chronological age. Prematurity has long been associated with worse outcomes in congenital heart disease [42,43]; however, while not specifically mentioned in the CRISP or rCRISP score [22], it must be taken into account. Interestingly, even late prematurity (37–39 week gestation) is associated with worse outcomes in patients with congenital heart disease [44–46]. The prevalence of congenital heart disease in premature infants is twice that of term infants [43]. Fetuses with congenital heart disease are also more likely to be born prematurely. Moreover, premature infants with congenital heart disease are more likely to have the complications of prematurity than those without [47,48]. All this leads to premature infants having a higher risk when it comes to procedures and novel lower-risk interventions being developed. This has been particularly evident in the management of the patent ductus arteriosus (PDA).
The prevention and management strategies for neonatal chronic lung disease
Published in Expert Review of Respiratory Medicine, 2023
Christopher Harris, Anne Greenough
A patent ductus arteriosus (PDA) for more than 10 days has been shown to increase the risk of BPD [82]. Whilst administering ibuprofen has been shown to successfully close PDAs, a Cochrane review did not find any evidence that it reduced the incidence of BPD when given prophylactically [83]. A multicentre, randomized trial attempted to recruit only those infants whose ducts were judged as haemodynamically significant enrolled 337 infants to receive either ibuprofen or no treatment [84]. The trial did not demonstrate any improvement in respiratory status with regard to ventilator days or the durations of noninvasive respiratory support or supplementary oxygen. There remains controversy regarding PDA management and its role in the pathogenesis of respiratory disease [85]. In a recently published multicentre RCT which included 273 infants, expectant management for PDA in infants born at less than 28 weeks of gestation was non-inferior to early ibuprofen treatment with respect to BPD [86].
CT findings in aggressive Takayasu arteritis
Published in Acta Cardiologica, 2022
Benjamín Roque Rodríguez, Luis Enrique Lezcano Gort, María Victoria Mogollón Jiménez, Ignacio Díaz Villalonga, Sergio Moyano Calvente, Zineb Kounka
A 52-year-old woman was referred to our hospital with grade-2 dyspnoea without intermittent claudication. She complained of self-limiting episodes of fever, asthenia, and myalgias since the adolescence. Physical examination revealed a loud panfocal systolic murmur (IV/VI), and large inter-arm blood pressure difference (180/80-120/70 mmHg in right and left arm respectively). Treponema pallidum serological-test and autoantibodies were negative, and acute phase reactants were normal. Doppler echocardiogram reveals doubtful patent ductus arteriosus. CT angiography with multiplanar (Figure 1, panels 1 and 4) and volumen-rendered reformatted images (Figure 1, panels 2 and 3) showed severe narrowing of the middle segment of the descending thoracic/abdominal aorta (a), and both iliac arteries, with intima-media thickening in all of them (b). Collaterals have been developed, like a huge and tortuous right internal mammary artery which anastomoses with branches of the epigastric arteries (c). We found severe stenosis in common carotid arteries (critical in left common carotid artery) (d) and in both subclavian arteries at the ostia of vertebral arteries(e). On the basis of clinical and angiographic abnormalities, the diagnosis of Takayasu arteritis (TA) was made. TA is a large-vessel granulomatous vasculitis that primarily affects the aorta and its primary branches, specially supraaortic trunk and subclavian artery. It principally affects young women. The patient refused to take any treatment or perform new tests. Actually, she remains asymptomatic.