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Question:

What should I do for my newly diagnosed PDA?

I've had two previous echoes done which showed mild mitral valve prolapse with very little regurgitation. Now this year, my echo has come back with a diagnosis of PDA. My GP is flabbergasted at that diagnosis since the two previous tests did not show this. Plus I had a cardiac CT about 11 years ago that showed nothing wrong. Should I have a cardiac MRI? What do you suggest? Could caffeine cause a false-positive? Thank you.   

submitted by Pamela from Arizona on 4/15/2014

Answer:

by Texas Heart Institute cardiologist, Raymond F. Stainback, MD    

Raymond F. Stainback, MDA patent ductus arteriosus (PDA) is sometimes diagnosed as an incidental finding in adults, usually when this shunt is very small. If indeed present, it is a disappointment that the prior echos & CT did not pick it up. On an echocardiogram there are two specific views that are used to pick this up, and a review of all the studies would be needed to see what went wrong. PDA's can sometimes be hard to detect, depending on the quality of imaging.  With PDA's there is a small risk for endocarditis to be aware of. If the shunt is large, closure (usually with a catheter procedure) can be considered. As far as CT imaging is concerned, the protocol would need to be a dedicated cardiac vascular protocol with contrast. Some CT scans of the chest may not pick up a small PDA. Additionally, the PDA flow can often be heard with a stethoscope (depending on size). I hope this is helpful. 

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Updated April 2014
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Texas Heart Institute Heart Information Center
Through this community outreach program, staff members of the Texas Heart Institute (THI) provide educational information related to the prevention, diagnosis, and treatment of cardiovascular disease. It is not the intention of THI to provide specific medical advice, but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided and THI urges you to visit a qualified physician for diagnosis and for answers to your questions.
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