Patent ductus arteriosus (PDA) is a congenital heart condition in which there is an opening between the pulmonary artery and the aorta.
Patent ductus arteriosus (PDA) is a congenital heart condition in which there is an opening between the pulmonary artery and the aorta. The ductus arteriosus is a small connection in the fetal heart helps oxygen rich blood to by-pass the immature baby’s lungs and flow into the body. This connection naturally closes shortly after birth. The connections that fail to close, are called patent ductus arteriosus, where the oxygen-rich and oxygen-poor combines together resulting in an increase in the workload of heart and various other complications.
It is the sixth most common type of congenital heart disease, and is frequently diagnosed in infants; although it may remain unknown until childhood or even adulthood.
The symptoms depend on the size of the patent duct and the gestational age of the neonate. A small patent ductus arteriosus can remain unrecognized until adulthood, whereas, a large patent ductus arteriosus may lead to life threatening conditions such as heart failure.
In neonates, a heart murmur on auscultation during regular checkup may indicate PDA.
In infants, a large PDA would show the following symptoms:
The symptoms in the case of adults with undiagnosed PAD include heart attack, atrial arrhythmia or with the occurrence of shunting of unoxygenated blood from pulmonary to systemic circulation.
In most of the children the cause of PDA is unknown, but genetic factors were thought to play a causative role. Every baby is born with ductus arteriosus which eventually narrows and closes within three to four days after birth. It may take longer time for closure in the case of premature babies. But if the duct doesn’t close, it may lead to an increase in the blood flow to the heart and lungs of the baby, which might enlarge or weaken the heart muscle.
The risk factors of having patent ductus arteriosus include:
A heart murmur heard during a regular checkup may lead to further work-up for PDA.
The following tests Are recommended for diagnosis of PDA:
Treatment is generally not considered, as the PDA usually closes on its own in the case of a premature baby. Close monitoring is considered for full term babies, children and adults with small PDA and with no other health complications. During follow-up, if the baby does not have any other complications, it is considered to be closed. On the other hand, if the baby has certain heart problems or defects, the ductus arteriosus might be lifesaving.
In a premature baby, it may take one to two years. But in full term babies, PDA that remains open after several weeks rarely closes on its own.
Medicines such as indomethacin or ibuprofen may be considered. These medicines work well for some newborns. The earlier treatment is given; greater are the chances for it to succeed.
Medical procedures may be considered in the case where medications are not effective. A transcatheter procedure is used to block blood flow through the vessel. An open heart surgery might be considered if the catheter procedure is not suitable to repair PDA.
Patent ductus arteriosus may not be prevented, but certain measures should be observed for a healthy pregnancy.