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PGE1 – duct-dependent lesion — RACP Paediatrics MCQ

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EasyCardiologyPGE1 – duct-dependent lesionRACP Paediatrics

A term neonate with critical coarctation of the aorta presents with absent femoral pulses and cardiovascular collapse on day 7. What is the most important immediate pharmacological intervention?

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Correct answer: E — PGE1 to maintain ductal patency

Prostaglandin E1 (alprostadil) infusion is required to reopen and maintain ductal patency in duct-dependent lesions. In critical coarctation, the ductus arteriosus is the only route for blood to reach the lower body. PGE1 side effects include apnoea (may require intubation), pyrexia, and vasodilation.

Reference: RCH Melbourne – 2023 – Cyanotic Newborn CPG; RACP Paediatric Curriculum – Cardiology