A. Collapsing pulse – Explanation
| Patent ductus arteriosus – collapsing pulse |
Patent ductus arteriosus
Overview
- acyanotic congenital heart defect
- connection between the pulmonary trunk and descending aorta
- more common in premature babies, born at high altitude or maternal rubella infection in the first
trimester
Features
- left subclavicular thrill
- continuous ‘machinery’ murmur
- large volume, bounding, collapsing pulse
- wide pulse pressure
- heaving apex beat
Management
- indomethacin closes the connection in the majority of cases
- if associated with another congenital heart defect amenable to surgery then prostaglandin E1 is
useful to keep the duct open until after surgical repair
