Other Auscultatory Signs of PDA

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1. What auscultatory signs of the increased flow through the mitral valve and large volume load on the LV may be heard in patients with a PDA?

ANS: There may be an S3 and/or a mitral diastolic flow murmur and the S2 split may be paradoxical.

2. What are the multiple clicks or crackles heard at the end of systole and the beginning of diastole called? Their significance?

ANS: Eddy sounds. They signify a large flow ductus [11]. PDA with High Pulmonary Artery Pressure

1. What causes differential cyanosis and clubbing (the feet cyanosed and clubbed, with the hand and face normal) in a PDA Eisenmenger situation, and why may the left hand be more cyanotic and clubbed than the right hand?

ANS: With pulmonary hypertension, unsaturated blood flows through a ductus from the pulmonary artery to the aorta. The ductus often joins the pulmonary artery to the aorta just beyond the left subclavian artery. Unsaturated pulmonary artery blood will then pass beyond the left subclavian artery, and both hands will be less clubbed and cyanotic than the feet. If, however, the ductus is at the junction of the aorta and the left subclavian artery, the left hand will be as cyanotic and clubbed as the feet.

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Coronary artery fistulas will often give a clue to their site of drainage by the site of the loudest murmur.

2. When will a right-to-left shunt (reversed ductus flow due to pulmonary hypertension) produce a murmur?

ANS: It is a general rule that right-to-left shunts do not produce murmurs.

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Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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