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The silent ductus arteriosus.

R L McGrath, G A McGuinness, G L Way

    The Journal of Pediatrics
    |July 1, 1978
    PubMed
    Summary
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    Many preterm infants with potential patent ductus arteriosus (PDA) have significant left-to-right shunts before showing clinical signs. Early echocardiography can detect these shunts, even without symptoms, aiding timely intervention for this common neonatal condition.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Cardiology
    • Medical Imaging

    Background:

    • Patent ductus arteriosus (PDA) is a common concern in preterm infants.
    • Early detection of PDA is crucial for preventing complications.

    Purpose of the Study:

    • To investigate the early detection of left-to-right shunts in preterm infants at risk for PDA.
    • To correlate subclinical shunts with later clinical presentation.

    Main Methods:

    • Sequential monitoring of preterm infants at risk for PDA.
    • Utilized physical examination, echocardiography (LA/AO ratio), and chest roentgenograms.
    • Confirmed shunts with retrograde single-film aortography.

    Main Results:

    • A significant number of infants without clinical PDA signs had large left-to-right shunts.

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  • Echocardiography revealed acute left atrial enlargement preceding shunt confirmation.
  • Clinical symptoms often lagged behind documented shunt presence.

    • Conclusions:

    • Subclinical left-to-right shunts are prevalent in at-risk preterm infants.
    • Echocardiography is effective in detecting early signs of PDA before clinical manifestation.
    • Timely diagnosis via imaging can improve management of neonatal PDA.