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Patent ductus arteriosus — MRCPCH FOP MCQ

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ModerateCardiologyPatent ductus arteriosusMRCPCH FOP

A premature 30-week infant remains oxygen dependent at 10 days of life. There is a bounding pulse, wide pulse pressure and a continuous murmur below the left clavicle. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Patent ductus arteriosus

A continuous murmur, bounding pulses and wide pulse pressure in a premature infant are classic for patent ductus arteriosus. Atrial septal defect usually gives a fixed split second heart sound rather than bounding pulses. Tetralogy is primarily a cyanotic lesion and does not cause a continuous ductal murmur. The pearl is that prematurity increases the likelihood of a clinically significant duct.

Reference: NICE CKS Congenital heart disease; BNFc Ibuprofen/indometacin