• Naomi A Adler, Eric R Snoey, and Sophie D Barbant.
• Department of Emergency Medicine, Alameda County Medical Center Highland Hospital, Oakland, California.
• J Emerg Med. 2013 Dec 1;45(6):e193-6.

BackgroundCongestive heart failure (CHF) is a common Emergency Department (ED) disorder that accounts for >5 million ED visits annually. Although quite rare, patent ductus arteriosus (PDA) is a serious cause of CHF that if left untreated can lead to life-threatening sequelae, such as hypertensive pulmonary vascular disease, endarteritis, and aneurysms of the ductus.ObjectiveTo discuss a case of PDA leading to CHF that illustrates one of the common complications of untreated PDA.Case ReportA 35-year-old woman presented to the ED with a 2-month history of shortness of breath, dyspnea on exertion, decreased exercise tolerance, and orthopnea. The physical examination revealed a 4/6 continuous machine-like murmur. In the presence of new CHF and an atypical murmur, a transthoracic echocardiogram was performed that confirmed the diagnosis of PDA. She underwent an uncomplicated percutaneous closure of the ductus with significant improvement in her symptoms.ConclusionsPersistent PDA in adulthood is a rare but important cause of CHF with significant morbidity and mortality if not appropriately diagnosed and treated.Copyright © 2013 Elsevier Inc. All rights reserved.

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