Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android

Key Features

  • Hyperdynamic precordium

  • Widened pulse pressure

  • Hypotension

  • Presence of a systolic heart murmur in many cases

Clinical Findings

  • Signs include a hyperdynamic precordium, increased peripheral pulses, and a widened pulse pressure with or without a systolic machinery type heart murmur

  • Early presentations are sometimes manifested by systemic hypotension without a murmur or hyperdynamic circulation

  • These signs are often accompanied by an increased need for respiratory support and metabolic acidemia


  • Echocardiogram confirms diagnosis


  • Medical or surgical ligation

  • Indomethacin

    • Dosage: 0.2 mg/kg intravenously every 12 hours for three doses

    • Can close clinically significant ductus in about two-thirds of cases

    • If the ductus reopens or fails to close completely, a second course of drug may be used or surgical ligation can be considered if the infant remains symptomatic

    • Can be used prophylactically

      • In the extremely low-birth-weight infant (< 1000 g) who is at very high risk for developing a symptomatic ductus

      • Dosage: 0.1 mg/kg every 24 hours for 3–5 days beginning on the first day of life

  • Ibuprofen lysine

    • Can be used as an alternative to indomethacin

    • Dosage: every 24 hours as an initial dose of 10 mg/kg and then 5 mg/kg for two doses

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.