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 04/15/2014

by Raymond F. Stainback, MD

A 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.