What is the role of chest radiography in the diagnosis of patent ductus arteriosus (PDA)?

Updated: Nov 20, 2018
  • Author: Luke K Kim, MD; Chief Editor: Stuart Berger, MD  more...
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Answer

Findings on chest radiographs range from normal to those consistent for congestive heart failure (CHF). Cardiomegaly may be present with or without CHF.

If significant left-to-right shunt through the patent ductus arteriosus (PDA) is present, the pulmonary arteries, pulmonary veins, left atrium, and left ventricle are enlarged on chest films. Also, the ascending aorta may be prominent.

Usually, chest radiographic findings are normal until the magnitude of the ratio of pulmonary to systemic circulation (QP/QS) exceeds 2:1. Prominence of the main pulmonary artery segment is an early sign of increased pulmonary artery pressure and flow. With marked pulmonary overcirculation, pulmonary edema may occur. Accentuated peripheral pulmonary vascular markings and increased pulmonary venous markings may be noted. In elderly individuals, the patent ductus arteriosus (PDA) may calcify and may be visible on a standard radiograph.

Studies have shown that chest radiographs have limited predictive value in determining which infants will benefit from ligation.


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