title: A rare presentation of patent ductus arteriosus in an adult patient with normal pulmonary hypertension and limb edema.
abstract: BACKGROUND
  Patent ductus arteriosus (PDA) at childhood is one of the five major and frequent congenital abnormalities, but it can be rarely seen in adults. Pulmonary hypertension (PHTN) and other presentations such as heart failure and edema are the identified complications of longstanding PDA, but adult case with no permanent heart symptoms and PHTN was rare. We reported a rare case of with an obvious PDA and normal pulmonary pressure.
  
  
  METHODS
  A 61-year-old woman presented with dyspnea (New York Heart Association class 2), chest pain, and lower limb edema. Echocardiogram showed; normal left ventricular chamber size and function, normal size of both atria. Furthermore, an obvious PDA (diameter = 6-7 mm) connecting the aortic arch to the pulmonary artery was reported in echocardiography. No lung congestion and evidence for PHTN was reported by computed tomographic angiography [Pulmonary capillary wedge pressure (PCWP) = 30 mmHg]. The patient was treated with antihypertensive drugs and after 1 and 3 months follow-up, edema and other symptoms were resolved.
  
  
  CONCLUSIONS
  Finally, we conclude that PDA in adulthood can present with nonspecific cardiovascular symptoms, and it seems that PHTN is not a fixed echocardiographic finding in these patients.
authors.affiliation: Associate Professor, Department of Cardiovascular Diseases, School of Medicine AND Cardiovascular Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Pishgoo
authors.affiliation: Researcher, Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Amin
authors.initials: A
authors.lastname: Saburi
authors.affiliation: Assistant Professor, Cardiovascular Research Center AND Department of Cardiovascular Diseases, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Arezoo
authors.initials: A
authors.lastname: Khosravi
keywords: Adults; Edema; Patent Ductus Arteriosus eri; Pulmonary Hypertension