Patent ductus arteriosus

In a fetus, the ductus arteriosus is a blood vessel that connects the main pulmonary artery and aorta. It allows blood to bypass the non-functional fetal lung. Normally it closes shortly after birth. If it remains open, it is called patent ductus arteriosus. PDA is the most common congenital heart defect in young animals. PDA causes a left-to-right shunt that leads to excessive volume loading of the left ventricle of the heart and consequently causes its dilatation and hypertrophy. This can lead to congestive heart disease and pulmonary edema. The most common symptom is a cough or shortness of breath.

PDA is most commonly manifested in purebred puppies of Maltese and similar breeds of dogs, like the Shetland sheepdog, Springer Spaniel, Bichon Frise, dwarf poodle, or Yorkshire terrier. Rarely PDA can cause pulmonary hypertension that reverses the direction of flow through the ductus arteriosus, causing hypoxemia and cyanosis.

Auscultation shows a continuous murmur on the left side of the heart with a strong base and a hyperkinetic femoral pulse. A systolic heart murmur is present, which may not be clearly audible because the pressure on the right and left side is almost identical and the flow of blood through the ductus arteriosus is minimal. Diagnosis is made by radiography and echocardiography.
Management of the disease is surgical hemodynamic support with necessary medications before surgery. Surgical correction is accomplished by ligation as soon as possible after diagnosis. Valvular regurgitation usually decreases after surgery due to the reduction of left ventricular dilatation.

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