Presentation
Grade 5/6 left basilar continuous murmur discovered at pre-spay evaluation.
Patient Data
On lateral radiographs, the left side of the heart is enlarged. The left atrium is visible as a triangular soft tissue opacity on the lateral view, and as a double density sign on the d/v.
On the d/v, the aorta has a prominent bulge at one o'clock, and the pulmonary artery is enlarged at two o'clock. The left auricle is also causing a slight bulge in the cardiac silhouette at the three o'clock position.
There is a prominent vascular pulmonary pattern with enlarged pulmonary arteries and veins throughout the lungs. These findings are consistent with patent ductus arteriosus.
Case Discussion
Echocardiogram showed the presence of a PDA with a dilated left ventricle and atrium and mild mitral regurgitation. The PDA allows high pressure blood to flow into the pulmonary artery, causing overcirculation of the lungs and volume overload of the heart. The bulges at the 1, 2 and 3 o'clock positions are characteristic of PDA.
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