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December 1964

Diastolic Murmur In Patent Ductus Arteriosus With Flow Reversal

Arch Intern Med. 1964;114(6):760-764. doi:10.1001/archinte.1964.03860120072005

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