Patent Ductus Arteriosus
photo and audio recording by Janelle Aby, MD interactive image provided by http://expand2web.com
When listening to newborns shortly after birth, murmurs created by the rapidly changing physiology of the cardiopulmonary circulation can frequently be heard. The infant here is 3 hours old. The murmur that can be heard above, loudest along the left sternal border, is consistent with a patent ductus arteriosus (PDA). Although pathologic PDA is classically described as a continuous "washing machine-like" murmur, when PDA is present just after birth, as part of a normal transition, it usually occurs as a soft systolic murmur which disappears in a few hours or a few days. The 2/6 murmur above, noticed on the first exam after birth, was gone by the following morning.
When listening to the left chest where the lung sounds are louder, notice the rapid respiratory pattern. At the time of this recording, the infant's respiratory rate was 120; this patient had transient tachypnea of the newborn. In this case, the murmur was physiologic and unrelated to the tachypnea, but congenital heart disease should always be considered when a murmur occurs in combination with respiratory symptoms.
. . . . . . 
