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Updated: Jun 7, 2026
09:31
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Unusual presentation for a patent ductus arteriosus
C D Vizza1, R Badagliacca, R Poscia
1Dept of Cardiovascular and Respiratory Disease, Sapienza University of Rome, Italy. dario.vizza@uniroma1.it
Summary
A rare case of severe pulmonary hypertension was diagnosed in a patient initially suspected of portopulmonary hypertension. Unexpectedly, a patent ductus arteriosus was identified as the underlying cause, highlighting the need for comprehensive cardiac evaluations.
Area of Science:
- Cardiology
- Pulmonary Hypertension
- Medical Diagnostics
Background:
- Portopulmonary hypertension (PPHTN) diagnosis can be challenging, especially in patients with co-existing conditions like hepatitis C and ascites.
- Rapid diagnosis is crucial for patients with severe symptoms, but standard workups may be precluded by poor condition.
Observation:
- Echocardiography revealed severe pulmonary hypertension (PH).
- Cardiac MRI showed right ventricular dilation and hypertrophy, atypical for common PH etiologies.
- CT angiography unexpectedly identified a partially calcified patent ductus arteriosus (PDA).
Findings:
- The patient presented with severe pre-capillary PH.
- Liver cirrhosis and portal hypertension were excluded.
- A patent ductus arteriosus was identified as the likely underlying cause of PH, not PPHTN.
Implications:
- Accurate diagnosis of the underlying cause of pulmonary arterial hypertension is critical.
- Atypical presentations of PH can occur in patients with congenital heart defects.
- Thorough investigation, including detailed right ventricular assessment and exclusion of shunts, is essential for correct PH diagnosis.
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