Definition

What is patent ductus arteriosus?

Patent ductus arteriosus (PDA) is a persistent opening between two major blood vessels leading from the heart. The opening, called the ductus arteriosus, is a normal part of a baby’s circulatory system before birth that usually closes shortly after birth. If it remains open, however, it’s called a patent ductus arteriosus.

A small patent ductus arteriosus often doesn’t cause problems and might never need treatment. However, a large patent ductus arteriosus left untreated can allow poorly oxygenated blood to flow in the wrong direction, weakening the heart muscle and causing heart failure and other complications.

How common is patent ductus arteriosus?

PDA is more common in girls than boys. The condition is more common in premature infants and those with neonatal respiratory distress syndrome. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of patent ductus arteriosus?

The common symptoms of patent ductus arteriosus are:

  • Poor eating, which leads to poor growth
  • Sweating with crying or eating
  • Persistent fast breathing or breathlessness
  • Easy tiring
  • Rapid heart rate

Patent ductus arteriosus symptoms vary with the size of the defect and whether the baby is full-term or premature. A small PDA might cause no signs or symptoms and go undetected for some time — even until adulthood. A large PDA can cause signs of heart failure soon after birth.

Your baby’s doctor might first suspect a heart defect during a regular checkup after hearing a heart murmur while listening to your baby’s heart through a stethoscope.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • Your baby tires easily when eating or playing
  • Your baby isn’t gaining weight
  • Your baby becomes breathless when eating or crying
  • Your baby always breathes rapidly or is short of breath

Causes

What causes patent ductus arteriosus?

Congenital heart defects arise from problems early in the heart’s development — but there’s often no clear cause. Genetics and environmental factors might play a role.

Before birth, a vascular connection (ductus arteriosus) between two major blood vessels leading from the heart — the aorta and pulmonary artery — is necessary for your baby’s blood circulation. The ductus arteriosus diverts blood from your baby’s lungs while they develop and the baby receives oxygen from the mother’s circulation.

After birth, the ductus arteriosus normally closes within two or three days. In premature infants, the connection often takes longer to close. If the connection remains open, it’s referred to as a patent ductus arteriosus.

The abnormal opening causes too much blood to circulate to the baby’s lungs and heart. Untreated, the blood pressure in the baby’s lungs might increase (pulmonary hypertension) and the baby’s heart might enlarge and weaken.

Risk factors

What increases my risk for patent ductus arteriosus?

There are many risk factors for patent ductus arteriosus, such as:

  • Premature birth. Patent ductus arteriosus (PDA) occurs more commonly in babies who are born too early than in babies who are born full term.
  • Family history and other genetic conditions. A family history of heart defects and other genetic conditions, such as Down syndrome, increase the risk of having a PDA.
  • Rubella infection during pregnancy. If you contract German measles (rubella) during pregnancy, your baby’s risk of heart defects increases. The rubella virus crosses the placenta and spreads through the baby’s circulatory system, damaging blood vessels and organs, including the heart.
  • Being born at a high altitude. Babies born above 10,000 feet (3,048 meters) have a greater risk of a PDA than babies born at lower altitudes.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is patent ductus arteriosus diagnosed?

Babies with PDA often have a heart murmur that can be heard with a stethoscope. However, in premature infants, a heart murmur may not be heard. The health care provider may suspect the condition if the infant has breathing or feeding problems soon after birth.

Changes may be seen on chest x-rays. The diagnosis is confirmed with an echocardiogram.

Sometimes, a small PDA may not be diagnosed until later in childhood.

How is patent ductus arteriosus treated?

Treatments for patent ductus arteriosus depend on the age of the person being treated. Options might include:

  • Watchful waiting. In a premature baby, a PDA often closes on its own. The doctor will monitor your baby’s heart to make sure the open blood vessel is closing properly. For full-term babies, children and adults who have small PDAs that aren’t causing other health problems, monitoring might be all that’s needed.
  • In a premature baby, nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen (Advil, Infant’s Motrin, others) or indomethacin (Indocin) — might be used to help close a PDA. NSAIDs block the hormonelike chemicals in the body that keep the PDA open. NSAIDs won’t close a PDA in full-term babies, children or adults.
  • Open-heart surgery. If medications aren’t effective and your child’s condition is severe or causing complications, open-heart surgery might be recommended. A surgeon makes a small cut between your child’s ribs to reach your child’s heart and repair the open duct using stitches or clips.After the surgery, your child will remain in the hospital for several days for observation. It usually takes a few weeks for a child to fully recover from open-heart surgery. Open-heart surgery might also be recommended for adults who have a PDA that’s causing health problems. Possible risks include hoarseness, bleeding, infection and a paralyzed diaphragm.
  • Catheter procedures. Premature babies are too small for catheter procedures. However, if your baby doesn’t have PDA-related health problems, the doctor might recommend waiting until the baby is older to do a catheter procedure to correct the PDA. Catheter procedures can also be used to treat full-term babies, children and adults.In a catheter procedure, a thin tube (catheter) is inserted into a blood vessel in the groin and threaded up to the heart. Through the catheter, a plug or coil is inserted to close the ductus arteriosus. If the procedure is done on an outpatient basis, your child probably won’t stay overnight in the hospital. Complications from catheter procedures include bleeding, infection, or movement of the plug or coil from where it was placed in the heart.

Preventive antibiotics

In the past, people who’ve had a PDA were advised to take antibiotics before dental work and certain surgical procedures to prevent a heart infection (infective endocarditis). Today, preventive antibiotics are no longer recommended for most people with a patent ductus arteriosus.

Your child may need to take preventive antibiotics the first six months after a catheter repair procedure or if there’s still damage after the repair. Talk to your doctor about whether your child needs to take antibiotics before any procedures.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage patent ductus arteriosus?

The following lifestyles and home remedies might help you cope with patent ductus arteriosus:

  • Preventing infection. For most people who have a patent ductus arteriosus, regularly brushing and flossing teeth and regular dental checkups are the best ways to help prevent infection.
  • Exercising and play. Parents of children who have congenital heart defects often worry about the risks of rough play and vigorous activity, even after successful treatment. Although some children might need to limit the amount or type of exercise, most people who have patent ductus arteriosus will lead normal lives. Your child’s doctor can advise you about which activities are safe for your child.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 21, 2017 | Last Modified: August 21, 2017

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