How good is clinical examination at detecting a significant patent ductus arteriosus in the preterm neonate?

Report By: DS Urquhart and RM Nicholl - Specialist Registrar in Paediatrics and Consultant Neonatologist respectively
Institution: Northwick Park Hospital, Watford Road, Harrow, Middlesex, UK
Current web editor: Bob Phillips - Section Editor, Archimedes
Date Submitted: 16th January 2003
Date Completed: 17th January 2003
Last Modified: 6th May 2003
Status: Green (complete)

Three Part Question

In a [ventilator dependant neonate of very low birth weight (<1000g)] [how good is clinical examination] at [detecting patent ductus arteriosus]?

Clinical Scenario

A 25 week gestation infant aged 30 days has a continuous murmur and easily palpable pulses. He has already received a course of indomethacin for a "clinically diagnosed" patent ductus arteriosus (PDA). The baby is ventilator dependent. How good (or bad) is clinical examination at diagnosing a clinically important PDA?

Search Strategy

PubMed, Cochrane Library, SUMSearch.
A search string of [patent arterial duct] AND [diagnostic test] was used.