What is the role of electrocardiography 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

With a small patent ductus arteriosus (PDA), the electrocardiographic (ECG) findings are typically normal. Left ventricular hypertrophy may be present with a larger PDA. Left atrial enlargement may also be present with large shunts. In the presence of significant pulmonary hypertension, there may be evidence of right ventricular hypertrophy.

In the neonate, especially the premature neonate with a large patent ductus arteriosus (PDA), T-wave inversion and ST segment depression may be present, suggesting ischemia or a supply-demand mismatch. This is thought to be related to increased myocardial work due to the left-to-right shunt and pulmonary overcirculation in the face of low aortic and coronary diastolic blood pressure due to the runoff of blood from the aorta into the pulmonary arteries.


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