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Patent Ductus Arteriosus — RACP Adult Medicine MCQ

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EasyCardiologyPatent Ductus ArteriosusRACP Adult Medicine

A 25-year-old woman has a continuous machinery murmur best heard in the left infraclavicular region. She has a wide pulse pressure (BP 140/50 mmHg) with bounding pulses. Echo shows a patent ductus arteriosus with left-to-right shunt and LV volume overload. Qp:Qs is 2.0:1. What is the most likely diagnosis?

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Correct answer: D — Patent ductus arteriosus

Continuous machinery murmur in the left infraclavicular region with wide pulse pressure and bounding pulses is PDA. In adults, small PDAs may be incidentally found. Significant PDAs (Qp:Qs >1.5:1 with LV volume overload) warrant closure. Percutaneous device closure is the standard approach for most PDAs. Surgical ligation is reserved for large or anatomically unfavourable PDAs.

Reference: ESC – 2024 – ACHD Guidelines; CSANZ 2024