Souza Georgia Rubiane, Barreto do Amaral Augusto, Busch Sarah, Villa Martignoni Felipe
Family Medicine, Complexo do Hospital de Clínicas da UFPR, Curitiba, BRA.
Internal Medicine, Central Montana Medical Center, Lewistown, USA.
Cureus. 2023 Nov 27;15(11):e49519. doi: 10.7759/cureus.49519. eCollection 2023 Nov.
Patent ductus arteriosus (PDA) is a rare finding in adults. The ductus arteriosus (DA) is responsible for shunting blood from the pulmonary artery into the aorta bypassing the lungs in fetal life (the placenta is responsible for fetal oxygenated blood). Its closure happens after birth, once fetal circulation transitions to normal postnatal circulation and blood oxygenates in the lungs. If the DA does not close, the PDA may continue to shunt blood from the systemic (higher pressure) to the pulmonary (lower pressure) circulation causing remodeling of the left ventricle and eventually heart failure. A PDA is suspected when there is a systolic/diastolic murmur in the left sternal border; a transthoracic or transesophageal echocardiogram may visualize the shunt and measure the systemic/pulmonary shunt ratio. We described a case of an 84-year-old elderly woman who presented with an acute heart failure exacerbation as the first symptom of PDA and was found to have left ventricular hypertrophy, right ventricular hypertrophy, and pulmonary hypertension as the initial presentation.
动脉导管未闭（PDA）在成年人中是一种罕见的病症。动脉导管（DA）在胎儿期负责将血液从肺动脉分流至主动脉，从而绕过肺部（胎盘负责为胎儿提供含氧血液）。出生后，一旦胎儿循环转变为正常的出生后循环且血液在肺部进行氧合，动脉导管就会闭合。如果动脉导管未闭合，PDA可能会继续将血液从体循环（较高压力）分流至肺循环（较低压力），导致左心室重塑并最终引发心力衰竭。当在左胸骨缘出现收缩期/舒张期杂音时，应怀疑存在PDA；经胸或经食管超声心动图可显示分流情况并测量体循环/肺循环分流比率。我们描述了一例84岁老年女性病例，该患者以急性心力衰竭加重作为PDA的首发症状，最初表现为左心室肥厚、右心室肥厚和肺动脉高压。
