Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with symptoms of significant left-to-right shunting, including tachypnea, diaphoresis during feeding, failure to thrive, and recurrent respiratory infections. History significant for poor weight gain and signs of congestive heart failure.
Clinical Examination Findings
Physical exam reveals a hyperdynamic precordium with a displaced apex beat. Auscultation demonstrates a continuous, machinery-like murmur heard best at the left upper sternal border, often associated with a thrill. Peripheral pulses are bounding with a wide pulse pressure.
Treatment Protocol
Management requires urgent closure of the ductus arteriosus. Options include pharmacological intervention (e.g., indomethacin or ibuprofen if neonate) or definitive surgical/transcatheter closure. Diuretic therapy and caloric supplementation initiated for heart failure stabilization.