Patent ductus arteriosus (PDA)

DEFINITION

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.

Treatment options for a patent ductus arteriosus include monitoring, medications and closure by cardiac catheterization or surgery.

CAUSES

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.

SYMPTOMS

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.

A large PDA found during infancy or childhood might cause:

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

When to see a doctor

Contact the doctor if your baby or older child:

• Tires easily when eating or playing
• Isn’t gaining weight
• Becomes breathless when eating or crying
• Always breathes rapidly or is short of breath