Patent ductus arteriosus: The Daily PANCE Blueprint

The answer is A. Indomethacin

Patent ductus arteriosus (PDA) is one of the most common congenital heart defects. It is defined by the failure of the ductus arteriosus (DA) to close within 72 hours after birth. The DA’s role during pregnancy is to shunt blood away from the non-working fetal lungs (i.e., the DA allows blood to be carried from RV, bypass the lungs, go through the aorta, and eventually to the placenta where gas exchange will occur). Risk factors include preterm status, low birth weight, high altitudes, genetic factors, and in utero exposure to rubella. Clinical features include wide pulse pressure, murmur, bounding pulses, respiratory failure, acidosis, and hypotension. Management includes fluid restriction, pharmacological agents (COX inhibitors like indomethacin) or possibly surgery for refractory cases.