Patent Ductus Arteriosus with Pulmonary Hypertension Simulating Ventricular Septal Defect Diagnostic Criteria in Ten Surgically Proven Cases

The classic findings of a patent ductus arteriosus in a young individual are familiar to most physicians. However, it has been appreciated that several factors, principally pulmonary hypertension or pulmonary artery dilatation in the absence of appreciable hypertension, may significantly alter the classic image and lead to the erroneous diagnosis of ventricular septal defect. In 10 surgically proved cases a patent ductus arteriosus was the sole malformation and so closely simulated a septal defect that extracorporeal circulation was initially considered for each of the patients. Division of the ductus resulted in a complete cure in all 10 patients. Those findings of value in differential diagnosis are analyzed. TIE classic picture of patent ductus arte-riosus in a young person, characterized by a continuous murmur, loudest over the pul-monic area, bounding peripheral pulses, in-creased pulmonary vascular markings, and other radiologic evidences of increased pulmo