Overview
Acyanotic congenital heart defect, with a connection between the pulmonary trunk and descending aorta. More common in premature babies, born at high altitude or maternal rubella infection in the first trimester.
Features
Left subclavicular thrill
Continuous 'machinery' murmur
Large volume, bounding, collapsing pulse
Wide pulse pressure
Heaving apex beat
Management
Indomethacin closes the connection in the majority of cases. If associated with another congenital heart defect amenable to surgery then prostaglandin E1 is useful in keeping the duct open until after surgical repair.
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