Patent ductus arteriosus in Malaysia

Area of Science:

• Cardiology
• Pediatric Cardiology
• Adult Congenital Heart Disease

Background:

• Patent Ductus Arteriosus (PDA) is a congenital heart defect more commonly diagnosed in infancy.
• Isolated PDA diagnosed after infancy represents a distinct clinical entity with unique challenges.
• Understanding the epidemiology and clinical presentation of late-diagnosed PDA is crucial for effective management.

Purpose of the Study:

• To review findings of isolated Patent Ductus Arteriosus diagnosed after infancy.
• To describe the clinical characteristics, diagnostic methods, and complications in a cohort of patients with late-presenting PDA.
• To provide insights into the management of PDA in older age groups.

Main Methods:

• Retrospective review of 181 patients with isolated PDA diagnosed after infancy.
• Data collected from University Hospital, Kuala Lumpur, between 1967 and 1975.
• Inclusion of patient demographics, age at diagnosis, sex ratio, presenting symptoms, and diagnostic procedures like cardiac catheterization.

Main Results:

• The study included 181 patients aged nine months to 54 years.
• Over 50% of patients were older than ten years at diagnosis.
• The female to male ratio was approximately 2.93:1.
• 32% of patients presented with significant effort dyspnea or heart failure.
• Common complications included elevated pulmonary vascular resistance, Eisenmenger syndrome, bacterial endocarditis, and cardiac failure.

Conclusions:

• Isolated PDA diagnosed after infancy is often associated with significant symptoms and potential complications.
• Late diagnosis of PDA can lead to severe sequelae, including pulmonary hypertension and heart failure.
• Early detection and intervention remain critical for improving outcomes in patients with PDA, regardless of age at diagnosis.