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Patent Ductus Arteriosus

What Is Patent Ductus Arteriosus?

Patent ductus arteriosus (PDA) is a fairly common congenital heart defect that occurs in about 3,000 newborns every year in the United States, according to the Cleveland Clinic. It occurs when a temporary blood vessel, called the ductus arteriosus, doesn’t close soon after birth. Symptoms may be minimal or severe. In rare cases, the defect can go undetected and can exist in adulthood. Correction of the defect is usually successful and restores the heart to its normal function.

In a normally functioning heart, the pulmonary artery carries blood to the lungs to collect oxygen. The oxygenated blood then travels through the aorta (the body’s main artery) to the rest of the body. In the womb, a blood vessel called the ductus arteriosus connects the aorta and pulmonary artery. It allows blood to flow from the pulmonary artery to the aorta and out to the body without going through the lungs. This is because the developing child gets oxygenated blood from the mother, not from their own lungs.

Soon after a baby is born, the ductus arteriosus should close up to prevent mixing oxygen-poor blood from the pulmonary artery with oxygen-rich blood from the aorta. When this doesn’t happen, the baby has patent ductus arteriosus (PDA). If a doctor never detects the defect, the baby may grow into an adult with PDA, although this is rare.

What Causes Patent Ductus Arteriosus?

PDA is a fairly common congenital heart defect in the United States, but doctors aren’t sure exactly what causes the condition. Premature birth can put babies at risk. PDA is more common in girls than boys.

What Are the Symptoms of Patent Ductus Arteriosus?

The opening in the ductus arteriosus can range from small to large. This means that symptoms may be very mild to severe. If the opening is very small, there may be no symptoms and your doctor may only find the condition by hearing a heart murmur.

Most commonly, an infant or child with PDA will have the following symptoms:

  • sweating
  • rapid and heavy breathing
  • fatigue
  • poor weight gain
  • little interest in feeding

In the rare case that PDA goes undetected, an adult with the defect may experience symptoms that include heart palpitations, shortness of breath, and complications such as high blood pressure in the lungs, an enlarged heart, or congestive heart failure.

How Is Patent Ductus Arteriosus Diagnosed?

A doctor will usually diagnose PDA after listening to your child’s heart. Most cases of PDA cause a heart murmur (an extra or unusual sound in the heartbeat), which a doctor can hear through a stethoscope. A chest X-ray may also be necessary to see the condition of a baby’s heart and lungs.

Premature babies may not have the same symptoms as full-term births, and may require additional tests to confirm PDA.

Echocardiogram

An echocardiogram is a test that uses sound waves to create a picture of the baby’s heart. It’s painless and allows the doctor to see the size of the heart. It also lets the doctor see if there’s any abnormality in blood flow. Echocardiogram is the most common method to diagnose PDA.

Electrocardiogram (EKG)

An EKG records the electrical activity of the heart and detects irregular heart rhythms. In babies, this test can also identify an enlarged heart.

What Are the Treatment Options for Patent Ductus Arteriosus?

In cases where the opening of the ductus arteriosus is very small, no treatment may be necessary. The opening can close as an infant gets older. In this case, your doctor will want to monitor the PDA as the baby grows. If it doesn’t close on its own, medication or surgical treatment will be necessary to avoid complications.

Medication

In a premature baby, a drug called indomethacin can help close the opening in PDA. When given intravenously, this medication can help constrict muscles and close off the ductus arteriosus. This type of treatment is typically only effective in newborns. In older infants and children, further treatment may be necessary.

Catheter-Based Procedures

In an infant or child with a small PDA, your doctor may recommend a “trascatheter device closure” procedure, according to the National Heart, Lung, and Blood Institute. This procedure is done as an outpatient and does not involve opening the child’s chest. A catheter is a thin flexible tube that is guided  through a blood vessel starting in the groin and is guided to your child’s heart. A blocking device is passed through the catheter and placed in the PDA. The device blocks the blood flow through the vessel and allows normal blood flow to return.

Surgical Treatment

If the opening is large or it doesn’t seal on its own, surgery may be necessary to correct the defect. This type of treatment is typically only for children who are six months or older. However, younger infants can have this treatment if they have symptoms. For surgical procedures, your doctor may prescribe antibiotics to prevent bacterial infection after leaving the hospital.

What Are the Complications Associated with Patent Ductus Arteriosus?

Most cases of PDA are diagnosed and treated soon after birth. It’s very unusual for PDA to go undetected into adulthood. If it does, however, it can cause several health problems. The larger the opening is, the worse the complications. However rare, untreated adult PDA can lead to other medical conditions in adults, such as:

  • shortness of breath or heart palpitations
  • pulmonary hypertension, or raised blood pressure in the lungs, which can damage the lungs
  • endocarditis, or inflammation of the lining of the heart due to a bacterial infection (people with structural heart defects are at a higher risk of infection)

In very serious cases of untreated adult PDA, extra blood flow can eventually increase the size of the heart, weakening the muscle and its ability to pump blood effectively. This can lead to congestive heart failure and death.

What Is the Long-Term Outlook?

The outlook is very good when PDA is detected and treated. Recovery for premature babies will depend on how early the baby was born and whether or not other illnesses are present. Most infants will make a complete recovery without experiencing any PDA-related complications.


Content licensed from:

Written by: Mary Ellen Ellis
Published on: Aug 15, 2012on: Jan 21, 2016

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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