{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:14:04Z","timestamp":1788185644450,"version":"build-2803163510"},"reference-count":18,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Patent ductus arteriosus (PDA) is a congenital cardiac anomaly most often diagnosed in infancy or childhood and infrequently detected in adulthood. In young adults, clinical and radiographic manifestations may be subtle and nonspecific, leading to delayed diagnosis. We report a case involving a 22-year-old previously healthy active duty female service member who presented with pleuritic chest pain at a forward-deployed medical facility in Djibouti, Africa. Chest radiographs were transmitted via teleradiology to a remotely located radiologist for interpretation. The radiologist identified discrete but abnormal findings consistent with pulmonary edema, including faint, patchy alveolar opacities, fine Kerley B lines at the lung bases, mildly prominent interlobar fissures, and trace bilateral pleural effusions, with an otherwise normal cardiac silhouette. Based on these findings, the radiologist recommended advanced cross-sectional imaging. Follow-up CT pulmonary angiography, obtained to rule out pulmonary embolism, identified a PDA with associated pulmonary overcirculation and left pulmonary artery enlargement, suggestive of pulmonary hypertension. This case demonstrates the critical role of teleradiology in extending expert imaging interpretation to austere, forward-deployed environments where on-site radiology subspecialty support is unavailable. The identification of subtle radiographic findings by a remote radiologist prompted further diagnostic evaluation, facilitating the diagnosis of occult congenital heart disease and appropriate medical evacuation.<\/jats:p>","DOI":"10.1093\/milmed\/usag410","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:52:58Z","timestamp":1787140378000},"source":"Crossref","is-referenced-by-count":0,"title":["Detection of Occult Patent Ductus Arteriosus Through Teleradiology in a Forward-Deployed Setting"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1419-1317","authenticated-orcid":false,"given":"Ryan","family":"Dinnen","sequence":"first","affiliation":[{"name":"Naval Medical Center Portsmouth , Portsmouth, VA 23708,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Cossetti","sequence":"additional","affiliation":[{"name":"Naval Medical Center Portsmouth , Portsmouth, VA 23708,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Kizhner","sequence":"additional","affiliation":[{"name":"Naval Medical Center Portsmouth , Portsmouth, VA 23708,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"2026083109183793900_usag410-B1","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1089\/tmj.2008.0018","article-title":"Telemedicine deployments within NATO military forces: a data analysis of current and projected capabilities","volume":"14","author":"Lam","year":"2008","journal-title":"Telemed J E Health"},{"key":"2026083109183793900_usag410-B2","doi-asserted-by":"publisher","first-page":"e462","DOI":"10.1093\/milmed\/usy127","article-title":"Telemedical support for military medicine","volume":"183","author":"Nettesheim","year":"2018","journal-title":"Mil Med"},{"key":"2026083109183793900_usag410-B3","doi-asserted-by":"publisher","first-page":"e1693","DOI":"10.1093\/milmed\/usaa091","article-title":"Reduction in medical evacuations from Iraq and Syria following introduction of an asynchronous telehealth system","volume":"185","author":"Nguyen","year":"2020","journal-title":"Mil Med"},{"key":"2026083109183793900_usag410-B4","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1093\/milmed\/usaf281","article-title":"A comprehensive review of the ADvanced VIrtual support for OpeRational forces (ADVISOR) program: Use and user feedback from","volume":"190","author":"Stern","year":"2025","journal-title":"Mil Med"},{"key":"2026083109183793900_usag410-B5","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.1377\/hlthaff.2019.00273","article-title":"Military telehealth: a model for delivering expertise to the point of need in austere and operational environments","volume":"38","author":"Pamplin","year":"2019","journal-title":"Health Aff (Millwood)"},{"key":"2026083109183793900_usag410-B6","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1148\/radiographics.19.6.g99no211507","article-title":"Clinical and radiologic features of pulmonary edema","volume":"19","author":"Gluecker","year":"1999","journal-title":"Radiographics"},{"key":"2026083109183793900_usag410-B7","doi-asserted-by":"publisher","first-page":"2788","DOI":"10.1056\/NEJMcp052699","article-title":"Clinical practice. 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