The Diagnosis of Patent Ductus Arteriosus in Infancy

¹ Assistant Professor of Pediatrics and Physiology, College of Medicine, University of Florida, Gainesville
² Professor of Radiology, Medical College of Virginia, Richmond
³ Associate Professor of Surgery, West Virginia University, School of Medicine, Morgantown

Thirty-nine infants with surgically proved patent ductus arteriosus were analyzed for clinical clues of diagnostic importance. The occurrence of rubella during pregnancy, a widened pulse pressure or a murmur heard during systole and diastole in the pulmonary area should alert the examiner to the possibility of patent ductus. In addition to those findings related to the presence of a left-to-right shunt, conventional x-rays films revealed left atrial enlargement in 31 and aortic knob enlargement in five instances. Comparison of the electrocardiograms with infants with VSD revealed no clues of differential diagnostic value, except possibly for presence of an upward concavity in the R-ST segment.

Because of the favorable surgical prognosis this diagnosis offers at any age a high index of suspicion and a willingness to perform special diagnostic procedure is warranted. In this institution we have come to favor the thoracic retrograde aortogram for diagnosis.