Lajpat Rai - Postgraduate Trainee, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
Uzair Yaqoob - ‎House officer, Jinnah Postgraduate Medical Centre, Karachi, Pakistan. ‎
Waleed Azam - Postgraduate Trainee, National institute of cardiovascular diseases, Karachi, ‎Pakistan
Hanisha Khemani - Postgraduate Trainee, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
Faizan ul-Haq - Resident medical officer, Tabba Heart institute, Karachi, Pakistan. ‎

Background: Patent ductus arteriosus (PDA) is one of the most common congenital heart ‎defects. It is usually diagnosed and treated soon after birth with only a few appearing in adults. ‎Here we present a case of PDA with calcifications diagnosed at the age of ۴۶ years. ‎Cardiological experts suspected multiple PDAs in this patient which can be the only case to ‎have appeared since we did not find any in the existing literature.‎ Case Presentation: A ۵۰-years-old female presented with shortness of breath and palpitations ‎since one month. Symptoms first started in ۲۰۰۲ and PDA was diagnosed in ۲۰۱۴. Family ‎history is positive for cardiovascular diseases. Echocardiography done in our setup showed ‎PDA with low pressure along with left ventricular dilation and reduced ejection fraction. ‎Electrocardiogram showed atrial fibrillation. She went for transcatheter closure of PDA but was ‎abandoned due to calcifications and multiple PDAs. She was then discharged on medications ‎and called for follow-up for referral to surgical department but the patient refused to have any ‎further intervention.‎ Conclusion: This occurrence of PDA at this stage of life shows the lack of resources in various ‎parts of our developing country. All required investigations should be done at their appropriate ‎time according to signs and symptoms so that each case is managed appropriately.‎

Patent Ductus Arteriosus, Adult, Multiple PDA, Palpitation, Congenital Heart ‎Disease, Dyspnea