A baby born at 34 weeks with a heart murmur is kept in the incubator for almost 4 weeks. There is no murmur at discharge. What is the likely cause of this murmur?
a. PDA
b. TOF
c. Aneurysm of sinus of Valsalva
d. Aorto-pulmonary septal defect
e. AVM
Q. 1. What is the key?
Q. 2. Why it was present in this baby?
Q. 3. If it is present after birth what is the management?
Ans. 1. The key is A. PDA.
Ans. 2. As it is more common in premature baby!
Ans. 3. Management:
• indomethacin closes the connection in the majority of cases
• if associated with another congenital heart defect amenable to surgery then prostaglandin E1 is useful to keep the duct open until after surgical repair.