Persistent patency of the ductus in adults is associated frequently with pulmonary hypertension and some degree of reversal of flow. Several investigators 1-3 have reported the "atypical" physical findings associated with this anomaly. Cases have been reported with either a systolic component to the murmur or no murmur at all.4 Clinicians are now alert to the possibility of a patent ductus arteriosus in patients without the characteristic Gibson murmur. However, a loud diastolic murmur and diastolic thrill in a patient with patent ductus arteriosus with reversal of flow has not previously been stressed.
Report of Case
A 36-year-old white housewife was admitted in July, 1962, to the Albany Medical Center Hospital for diagnostic studies. She is said to have been born with a "leaking heart valve." Throughout childhood, she had to limit her activities, as she tired easily, became short of breath on running, and was frequently cyanotic. At
ROSENTHAL R. Diastolic Murmur In Patent Ductus Arteriosus With Flow Reversal. Arch Intern Med. 1964;114(6):760-764. doi:10.1001/archinte.1964.03860120072005