[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-533587-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-533587-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","patent-ductus-arteriosus-diagnosis-and-educational-objective","Patent Ductus Arteriosus - Diagnosis and Educational Objective","","Presents two clinical question items from a congenital heart disease and prenatal care context. The first case describes a 6-month-old with peripheral pulse accentuation and left sternal border auscultation findings, leading to a continuous murmur maximal at S2, supporting patent ductus arteriosus (PDA). The explanation details hemodynamics, typical auscultation locations, and symptom variability by duct size, and contrasts incorrect options such as ASD, mitral valve prolapse, and Williams syndrome. The second item outlines prenatal risk assessment at 16 weeks after prior cold knife conization and asks which intervention is indicated.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/exam/","Exam",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/patent-ductus-arteriosus-diagnosis-and-educational-objective/533587/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/patent-ductus-arteriosus-diagnosis-and-educational-objective/533587.png","ImageObject",300,407,{"name":42,"@type":43},"LangkahRina","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-27","2026-10-10",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"Why does patent ductus arteriosus produce a continuous murmur maximal at S2?","Question",{"text":62,"@type":63},"PDA creates continuous flow from the high-pressure aorta to the low-pressure pulmonary arterial trunk throughout the cardiac cycle. The murmur is typically best heard in the left infraclavicular or posterior interscapular region and is often maximal at S2 due to the peak aortic pressure.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How do symptoms of a patent ductus arteriosus vary with duct size?",{"text":67,"@type":63},"A small PDA is often asymptomatic and found incidentally. A larger PDA may cause respiratory distress and poor feeding with poor growth during the first year, and relatively large PDAs can lead to high cardiac output and hyperdynamic circulation, eventually contributing to left ventricular failure.",{"name":69,"@type":60,"acceptedAnswer":70},"Which features help distinguish other options from PDA?",{"text":71,"@type":63},"ASD classically produces a murmur related to right-sided volume overload across the pulmonic valve rather than a continuous murmur from systemic-to-pulmonary flow. Mitral valve prolapse typically causes a midsystolic click with a late systolic murmur at the apex. Williams syndrome is associated with supravalvular aortic stenosis causing a systolic crescendo-decrescendo murmur.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},533587,1792633385,{"code":4,"msg":81,"data":82},"success",[83,87,91,94,99,104,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":92,"slug":93},70,"exam",{"id":95,"doc_module":4,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},5,"Comic",60,"comic",{"id":100,"doc_module":4,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},6,"Technology",50,"technology",{"id":105,"doc_module":4,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},7,"Healthcare",40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":95,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":33,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":30,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},962090893776,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","●●●  \nAA  \nItem 1 of 40  \nQuestion Id:4912Mark  \n# PreviousNextFull ScreenTutorialLab ValuesNotesCalculatorReverse Color\n\nThis item has associated media that may require the use of headphones.Please ensure your system/speaker volume is set to an audiblelevel.  \nA6-month-old boy is brought to the office for a routine checkup.He has met all expected developmental milestones,and all of his vaccinationsare up to date.On physical examination,the patient's peripheral pulses are somewhat accentuated.Cardiac auscultation findings at the leftsternal border are given below.What is the most likely diagnosis in this patient?  \nPlay Media  \nText Zoom  \nSettings  \n○ A.Endocardial cushion defect○ B.Mitral valve prolapse○ C.Patent ductus arteriosus○ D.Williams syndrome  \nSubmit  \n●◎  \nItem 1 of 40  \nQuestion Id:4912Mark  \nPreviousNextFull ScreenTutorialLab ValuesNotesCalculatorReverse ColorText Zoom  \nThis patient's auscultation findings reveal a continuous murmur with maximal intensity at S2,which is characteristic of a patent ductus arteriosus(PDA).The murmur is caused by continuous blood flow through the PDA(because aortic pressure exceeds pulmonary arterial pressurethroughout the cardiac cycle).It is usually best heard at the left infraclavicular or posterior interscapular region.Its maximal intensity istypically at S2,when pressure in the aorta is at its peak.  \nThe symptoms caused by a PDA are variable depending on its size and the resulting degree of left-to-right shunting from the aorta to thepulmonary arterial trunk.Asmall PDA is often asymptomatic and detected incidentally via cardiac auscultation whereas a larger PDA may presentwith respiratory distress,poor feeding,and/or retracted growth within the first year of life.Relatively large PDAs can cause high cardiac outputand hyperdynamic circulation (eg,accentuated peripheral pulses)due to the left ventricle compensating for the significant reduction in systemicvascular resistance created by the PDA shunt.The resulting overcirculation of the lungs and left side of the heart can eventually lead to leftventricular failure.  \n(Choice A)Endocardial cushion defects are common with Down syndrome(eg,septum primum defects)and can cause an atrial septal defect(ASD)often with involvement of the atrioventricular valves(eg,causing mitral or tricuspid regurgitation).These defects do not cause a continuousmurmur.The typical murmur of an ASD is not caused by blood flow through the defect itself (as there is a low-pressure difference between theatria)but results from right-sided volume overload with increased blood flow across the pulmonic valve (ie,pulmonic flow murmur).  \n(Choice B)Mitral valve prolapse classically causes a midsystolic click followed by a late systolic murmur of mitral regurgitation (best heard at thecardiac apex).The timing of the click(and murmur)varies with changes in left ventricular blood volume.  \n(Choice D)Williams syndrome is commonly associated with supravalvular aortic stenosis (due to narrowing of the proximal aorta),which createsa crescendo-decrescendo systolic murmur similar to that of valvular aortic stenosis.  \n## Educational objective:\n\nA patent ductus arteriosus causes a continuous flow murmur due to constant movement of blood from the high-pressure aorta to the low-pressurepulmonary arterial trunk.  \nMedical Library  \n## Overview of congenital heart diseases\n\nCardiovascular System  \nPatent ductus arteriosus  \nPediatrics  \nSubject  \nSystem  \nTopic  \nSettings  \n●●●  \nAA  \nItem 1 of 40Question Id:4912Mark[]PreviousNextFull ScreenTutorialLab ValuesNotesCalculatorReverse ColorText Zoom  \nThis patient's auccultation findinae rovoalacontinuoLc murmrwith mavimalintoncitv at S2 which ic choractorictic ofa natont ductue artoriocuc  \n(PDA).The Exhibit Displaythroughout tltypically at S  \nThe symptor  \npulmonary a  \nSettings  \nwith respirat  \nand hyperd  \nvascular res  \nventricular fa  \n(Choice A)  \n(ASD)often  \nmurmur.Th  \natria)but res  \n(Choice B)  \ncardiac ape>  \n(Choice","cbCaiiZFdvqA66lf","https://ap.wps.com/l/cbCaiiZFdvqA66lf","pdf",44845682,154,"English","# Educational objective\n## Overview of congenital heart diseases\n## Hemodynamics of patent ductus arteriosus","[{\"question\":\"Why does patent ductus arteriosus produce a continuous murmur maximal at S2?\",\"answer\":\"PDA creates continuous flow from the high-pressure aorta to the low-pressure pulmonary arterial trunk throughout the cardiac cycle. The murmur is typically best heard in the left infraclavicular or posterior interscapular region and is often maximal at S2 due to the peak aortic pressure.\"},{\"question\":\"How do symptoms of a patent ductus arteriosus vary with duct size?\",\"answer\":\"A small PDA is often asymptomatic and found incidentally. A larger PDA may cause respiratory distress and poor feeding with poor growth during the first year, and relatively large PDAs can lead to high cardiac output and hyperdynamic circulation, eventually contributing to left ventricular failure.\"},{\"question\":\"Which features help distinguish other options from PDA?\",\"answer\":\"ASD classically produces a murmur related to right-sided volume overload across the pulmonic valve rather than a continuous murmur from systemic-to-pulmonary flow. Mitral valve prolapse typically causes a midsystolic click with a late systolic murmur at the apex. Williams syndrome is associated with supravalvular aortic stenosis causing a systolic crescendo-decrescendo murmur.\"}]","Patent Ductus Arteriosus - Diagnosis and Educational Objective | PDF",1791592826,388]