title: To evaluate the prevalence of symptomatic and non-symptomatic ductus arteriosus and accuracy of physical signs in diagnosing PDA in preterm infants using blinded comparison of clinical and echocardiographic findings during the first week of life: a prospective observational study from Iran.
abstract: OBJECTIVE
  To evaluate the prevalence of symptomatic and non-symptomatic ductus arteriosus (PDA) and accuracy of physical signs in diagnosing PDA in preterm infants using blinded comparison of clinical and echocardiographic findings during the first week of life.
  
  
  METHODS
  This prospective observational cross-sectional study enrolled 200 preterm infants, who underwent echocardiography on 4th-7th postnatal day. The neonates who were diagnosed to have PDA on echo were observed for clinical features of PDA to label it symptomatic PDA. Symptomatic PDA was defined as detecting one or all of these symptoms in a neonate with PDA: bounding pulse, pericardial hyperactivity, systolic or continuous murmur.
  
  
  RESULTS
  Forty-five infants had PDA on echocardiography. 66.7% neonates with PDA were symptomatic and the most prevalent symptom in them was heart murmur (100%) either alone or combined with other clinical features. Isolated murmur was seen in 31.2%, murmur and hyperdynamic precordium was seen in 8.8%, murmur and bounding pulses were seen in 6.67% and all three features simultaneously were seen in 20% of infants. The sensitivity of murmur for diagnosing symptomatic PDA was highest.
  
  
  CONCLUSIONS
  Presence of murmur is the most important clinical feature for diagnosis of symptomatic PDA and has good specificity.
authors: a Neonatal Research Center, Shiraz University of Medical Sciences , Shiraz , Iran.
authors: Shahnaz
authors: S
authors: Pourarian
authors: b NEOCLINIC, Plot number 3 & 4, Everest Vihar, Opposite Krishna Heart Hospital, TN Mishra Marg, Nirman Nagar , Jaipur , Rajasthan , India.
authors: Deepak
authors: D
authors: Sharma
authors: c Department of Pediatrics , Shiraz University of Medical Sciences , Shiraz , Iran.
authors: Nazanin
authors: N
authors: Farahbakhsh
authors: d Department of Pediatric Cardiology , Shiraz University of Medical Sciences , Shiraz , Iran , and.
authors: Sirous
authors: S
authors: Cheriki
authors: e Department of Orthopedics , Shiraz University of Medical sciences , Shiraz , Iran.
authors: Farhad
authors: F
authors: Bijanzadeh
mesh_terms: D058070:Asymptomatic Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000453:epidemiology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007492:Iran / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies
keywords: Echocardiography; bounding pulse; patent ductus arteriosus; pericardial hyperactivity; symptomatic PDA; systolic or continuous murmur