The ductus arteriosus connects the pulmonary artery and the descending aorta; it is described as persistent if it remains open 1 month after the estimated delivery date, if it remains patent blood flows from the aorta to the pulmonary artery (left to right shunt)

Common in preterm neonates due to a defect in the constriction of the duct following birth

Continuous machinery murmur beneath the left clavicle

Usually asymptomatic

Large ducts may be symptoms of heart failure and pulmonary hypertension

ECG: usually normal

Chest X-Ray: usually normal but large ducts may have increased pulmonary 

vasculature

Echo: Assess for structural abnormality and confirm defect

Conservative Management: May close spontaneously

Medical: Treat symptoms of heart failure, Indomethacin – a prostaglandin 

inhibitor to assist in closure in infancy

Surgical: Ligation may be required if medical management fails