Echocardiography in the differential diagnosis of patent ductus arteriosus in children

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Abstract

The aim of this study was to attempt to carry out the analysis and interpretation of the clinical course of the disease in children with documented congenital heart disease - patent ductus arteriosus. To compare the data with the size of auscultation of patent ductus arteriosus and the direction to be bypassed through the blood stream, obtained during routine echocardiography. Using echocardiography to examine abnormal diastolic flow in the pulmonary artery trunk, simulating patent ductus arteriosus. Echocardiography was performed in 2173 a child under the age of 1 day of life to 18 years. Of these outpatient echocardiographic study was performed in 1503 children permanently surveyed 670 children. Patent ductus arteriosus was diagnosed in 66 children, which made up 3% of the total surveyed. Of these, 48 girls and 18 boys (ratio 2.6 : 1). In the classification of the identified patent ductus arteriosus, we have a new form of it has been identified and proposed - a continuously recurrent, which met in 5 children. When comparing the data auscultation with different kinds of patent ductus arteriosus was found that the classic “machine” systolic-diastolic murmur, accompanied by only 20% of defects, 60% of the children to listen to a systolic murmur in the 2-3 intercostal space on the left in the sternum, in some cases accompanied by focus 2nd tone of the pulmonary artery. The remaining 20% of the children surveyed, a significant auscultatory pattern generally absent. The paper presents the criteria for echocardiographic diagnosis between patent ductus arteriosus, and pulmonary and aorto-coronary-pulmonary fistulas, and fistulas. It is shown that when rendering the bifurcation of the pulmonary artery from the left parasternal short-axis access, deficiency or complete absence of tissue in the projection of aorto-pulmonary ligaments (ligamentum arteriosum), may indicate the presence of a patent ductus arteriosus.

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About the authors

Nikolaj F Prijma

St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: nicprijma@rambler.ru
MD, PhD, Senior researcher Russian Federation

Valeriy V Popov

St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation

Email: nicprijma@rambler.ru
MD, PhD, Head, Laboratory of New Medical Technologies, Research Сenter Russian Federation

Dmitry O Ivanov

St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation

Email: doivanov@yandex.ru
MD, PhD, Dr Med Sci, Professor, Rector, Сhief Neonatologist, Ministry of Health of the Russian Federation Russian Federation

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