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Persistent Reactivity of Patent Ductus With a Review of the Mechanism of Spontaneous Closure

DAVID Z. FRIEDBERG, MD; RANJIT S. RAJPAL, MD; S. BERT LITWIN, MD; JOSEPH ZONDLO, MD
Am J Dis Child. 1981;135(5):472-473. doi:10.1001/archpedi.1981.02130290068022.
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The ductus arteriosus is reactive to a number of chemical stimuli. These include arterial oxygen tension, catecholamines, kinins, and prostaglandins. Prostaglandin E has been used to maintain the patency of the ductus arteriosus in infants with certain forms of congenital heart disease. Similarly, prostaglandin inhibitors are useful as medical treatment to induce spontaneous closure of the ductus arteriosus in premature infants. We report the persistence of this reactivity of a ductus arteriosus in a 3.5-year-old child, a phenomenon not yet reported in this age group.

Report of a Case.—The patient was a 3.5-year-old twin. The patient was asymptomatic and her twin was unaffected. On physical examination the heart rate was 142 beats per minute, and the blood pressure was 100/60 mm Hg in the right arm. The apical impulse was located at the left fifth intercostal space in the mediclavicular line. There was a prominent thrill in the second

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