PDA Murmur Characteristics

Diagnostic Findings

• The American College of Cardiology notes that a continuous machinery murmur is typically heard in patients with PDA, most prominently in the left infraclavicular area and left upper sternal border 1
• The American Heart Association recommends that a wide pulse pressure is often associated with moderate to large PDA, and is an important diagnostic finding 1
• In cases of small or audible PDA, a continuous murmur may be heard on auscultation, but is often hemodynamically insignificant 2, 3, 4, 5
• For silent or trivial PDA, no murmur is heard on auscultation, and the condition is often hemodynamically insignificant 2, 3, 4, 5
• The American College of Cardiology states that if a continuous murmur is heard more prominently on the right side, other conditions such as aorto-right atrial fistula, coronary arteriovenous fistula, or ruptured sinus of Valsalva should be considered 1
• Definitive diagnosis of PDA requires echocardiography, with color Doppler and continuous wave Doppler used to estimate pulmonary artery pressure 1, 2

Echocardiography

• The American Society of Echocardiography recommends that parasternal short-axis view with color Doppler is essential for diagnosing PDA 1, 2
• Continuous wave Doppler should be used to measure the pressure gradient across the pulmonary artery, allowing for estimation of pulmonary artery pressure 1, 2