Patent ductus arteriosus

Discussion:

The ductus arteriosus is a vascular channel that connects the proximal descending aorta to the roof of the main pulmonary trunk near the origin of the left pulmonary artery. It normally closes spontaneously within 24 to 48 hours after birth due to increased oxygen tension and reduced prostaglandin levels. Failure of this closure results in a patent ductus arteriosus (PDA).

PDA is uncommon in adults as it is usually identified and treated during childhood. It results in left to right shunting and clinically manifests as a continuous murmur loudest at the upper left sternal edge.

Definitive treatment is closure either via transcatheter approach or surgical ligation.

In the setting of trauma, distinction between a PDA and traumatic aortic injury is obviously crucial. In this case, the anatomical location, lack of mural irregularity, as well as the absence of mediastinal hematoma or any other significant chest injuries aids in making the diagnosis.

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