Patent ductus arteriosus presenting in old age

Area of Science:

• Cardiology
• Geriatric Medicine
• Medical Case Reports

Background:

• Patent ductus arteriosus (PDA) is a congenital heart defect typically diagnosed in infancy or childhood.
• Late presentation of PDA in adulthood is rare, and even rarer in advanced old age.
• This case highlights the potential for congenital heart anomalies to remain undiagnosed until late in life.

Observation:

• An elderly female presented with symptoms of chest pressure and dyspnea.
• The patient subsequently developed subacute bacterial endocarditis, a serious complication of untreated PDA.
• She also exhibited electrocardiogram (ECG) changes consistent with typical angina pectoris.

Findings:

• The patient was diagnosed with patent ductus arteriosus (PDA) at an advanced age, making her the oldest reported female case in the medical literature.
• Coronary anatomy was found to be normal, ruling out coronary artery disease as the cause of angina.
• The clinical presentation included symptoms suggestive of heart failure and complications arising from the PDA.

Implications:

• This case underscores the importance of considering congenital heart disease in the differential diagnosis of cardiovascular symptoms in the elderly.
• Late diagnosis of PDA can lead to severe complications such as bacterial endocarditis and heart failure.
• Further research into the long-term natural history and management of adult-presenting PDA is warranted.