Patent Ductus Arteriosus (PDA) Differential Diagnoses

Updated: Dec 26, 2016
  • Author: Luke K Kim, MD; Chief Editor: Stuart Berger, MD  more...
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DDx

Diagnostic Considerations

Distinguishing between clinically significant and nonsignificant patent ductus arteriosus (PDA) is important. A clinically significant patent ductus arteriosus (PDA) is characterized by respiratory problems with ventilation difficulties, coupled with pulmonary congestion with tachycardia, bounding pulses, and metabolic acidosis. The left-to-right shunt leads to an increased risk of complications that include intraventricular hemorrhage, narcotizing enterocolitis, chronic lung disease, and death.

Note that congestive heart failure (CHF) may be mistaken as an upper respiratory infection (URI) in some cases.

Other conditions that should be considered when evaluating a patient with suspected patent ductus arteriosus (PDA) include the following:

  • Absence pulmonary valve syndrome
  • Acute anemia
  • Aortic regurgitation
  • Aortopulmonary window (aortopulmonary fenestration)
  • Atrioventricular malformation
  • Bacteremia and sepsis
  • Bronchial pulmonary artery stenosis
  • Cardiogenic shock
  • Cervical venous hum (usually present on the right side of the neck and more prominent in the sitting position, varying with respiration)
  • Dilated cardiomyopathy
  • Mitral regurgitation
  • Ruptured sinus of Valsalva and fistula
  • Peripheral pulmonary artery stenosis
  • Persistent truncus arteriosus
  • Pulmonary arteriovenous fistula
  • Systemic arteriovenous fistula (cerebrovascular or hepatic arteriovenous malformations)
  • Total anomalous pulmonary venous return
  • Venous hum
  • Ventricular septal defect (VSD) with aortic regurgitation

Differential Diagnoses