PDA or another vascular anomaly?

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PDA or another vascular anomaly?

  • 3 years old
  • no hemodynamic repercussion
  • At first I thought it was PDA, but the location is different. Does anyone have any ideas? Arteriovenous fistula? Coronary?

Comments

EL

Looks pda to me the CF is

Looks pda to me the CF is holosystolic flow and too deep and wrong flow for PS and the PV looks ok. Is there a machinery murmur on auscoltation? Ill see if Peter can chime in as well.

Peter

Hi!
I completely agree with

Hi!

I completely agree with Eric.  Very likely a PDA. A bronchiopulmonary fistula is difficult to rule out here but rather unlikely.

 

Some Comments on scanning technique:

Great you tried to identify the PDA from both sides!

I would recommend trying to follow to color signal to it’s origin. This makes it easier to find a small PDA opening or a small PDA. On your left sided view I see the PA and AO as well a continuous signal but I can’t see the opening of the PDA. Given  the relatively low pressure gradient I assume that the PDA is small and the flow is not in optimal alignment. Also, your Nyqust limit is low which makes it difficult to identify the direction of the jet.

Summarizing, I would follow the saying: If you hear hooves, think of a horse, not of a zebra. I will post 2 videos of a short coronary fistula in a new thread

Thx

 

Peter

 

 

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