Atypical patent ductus arteriosus with absence of the usual aortic-pulmonary pressure gradient and of the characteristic murmur
| Autor: | Gordon S. Myers, J. Gordon Scannell, Stanley M. Wyman, Grey Dimond, John Willis Hurst |
|---|---|
| Rok vydání: | 1951 |
| Předmět: |
Heart Defects
Congenital congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Systolic Murmurs Heart Diseases medicine.medical_treatment Diastole Aneurysm Internal medicine Ductus arteriosus Humans Medicine cardiovascular diseases Angiocardiography Ductus Arteriosus Patent Cardiac catheterization medicine.diagnostic_test Cardiac cycle business.industry Ductus Arteriosus medicine.disease medicine.anatomical_structure Heart failure cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | American Heart Journal. 41:819-833 |
| ISSN: | 0002-8703 |
| DOI: | 10.1016/0002-8703(51)90115-9 |
| Popis: | The clinical criteria for the diagnosis of patent ductus arteriosus are well known and are, in the vast majority of cases, sufficient to establish the diagnosis without recourse to cardiac catheterization or to angiocardiography. Of these criteria, a continuous machinery murmur best heard at the left of the upper sternum has been considered typical of patent ductus and is rarely of other origin (i.e., arteriovenous aneurysm in the same area). However, the earlier insistence that this typical murmur must be present in order to justify surgical exploration1,2 has proved untenable. Furthermore, it has been pointed out3,4 that in infancy or with congestive heart failure a patent ductus may be present with-out murmurs. Several proved cases3,5 have been reported in which only systolic murmurs not continuing into diastole were found. Why does a patent ductus arterious occasionally fail to give rise to a continuous murmur? Burchell5 suggested that in these cases the usual aortic-pulmonary pressure gradient may be absent during diastole or during the entire cardiac cycle. However, no data bearing on this point have thus far been available. In this paper we present two cases of patent ductus arteriosus in children who did not exhibit the classic machinery murmur. In the preoperative evaluation of these patients, cardiac catheterization was helpful in making the diagnosis and, in one of the cases, furnished data which satisfactorily explained the lack of typical physical signs. |
| Databáze: | OpenAIRE |
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