What are physical findings suggestive of persistent pulmonary hypertension of the newborn (PPHN)?

Updated: Sep 03, 2019
  • Author: Kate A Tauber, MD; Chief Editor: Howard S Weber, MD, FSCAI  more...
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Answer

Answer

Persistent pulmonary hypertension of the newborn (PPHN) most typically affects infants who are phenotypically normal, although PPHN occurs with higher frequency in newborns with Down syndrome [28]  and structurally normal hearts.

The most characteristic findings in an infant with PPHN are hypoxemia and a preductal-postductal saturation gradient. Infants will often have signs of respiratory distress, wide swings in arterial oxygenation levels due to acute changes in pulmonary blood flow and right-to-left shunting, and a cardiac examination revealing a loud, single second heart sound with a harsh murmur due to tricuspid regurgitation.

The patient may also present with systemic hypotension and symptoms of shock with echocardiographic evidence of poor right ventricular systolic function.


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