Patent Ductus Arteriosus

Patent ductus arteriosus (PDA) is a heart condition that involves having a persistent opening in between two major blood vessels that lead from the heart. An unborn baby’s circulatory system has this opening (ductus arteriosus), and then closes soon after birth. In some cases, however, it remains open (Patent ductus arteriosus).

A small opening usually won’t cause problems and may be left untreated. A large Patent ductus arteriosus, on the other hand, can cause problems when left untreated. It can let poorly oxygenated blood to flow backwards, which may cause weakening of the heart muscle that leads to complications like heart failure.

Treatment options include close monitoring, medications, catheterization, and surgery.

The symptoms of patent ductus arteriosus vary depending on the size of the gap. It also depends on whether the baby is born full-term or not. Most people with small PDA experience no signs or symptoms and the hole can go undetected even until the adult years. However, with a large PDA, signs of a heart condition usually take place soon after birth. 

During the baby’s regular checkup, the baby’s doctor might hear a heart murmur during a routine listening to the baby’s heart using a stethoscope. Usual symptoms of a large PDA found during infancy or childhood include:

• Poor eating
• Sweating when crying or eating
• Breathlessness 
• Rapid heart rate
• Easy tiring

Some suspected causes of patent ductus arteriosus (PDA) include environmental factors and genetics. PDA, like other congenital heart defects, usually take place in the early stages of heart development. 

Your child’s doctor may suspect a PDA due to a heart murmur. It may be found immediately after birth or discovered a little later. If a heart murmur is present, the doctor may refer you to a cardiologist or pediatric cardiologist. 

Your child's doctor might diagnose patent ductus arteriosus based on heartbeat.

Oftentimes, a lot of things are needed to be discussed, especially in this case. So, it is ideal that you get some notes ready, including:

• The list of signs and symptoms 
• List of medications, supplements and vitamins, if there are any

Also, bring copies of medical records of the child, including imaging tests and previous surgery reports, if available.

Your child may need to undergo several tests and procedures if the doctor suspects a heart problem. These tests include:

• Echocardiogram. The test, which utilizes sound waves in producing images of the heart, is used to evaluate the valves of the heart, as well as to detect other possible heart defects. 
• Chest X-ray. Apart from showing the condition of the baby’s lungs, an X-ray may also reveal heart defects and other conditions, too.
• Electrocardiogram (ECG). This procedure helps in diagnosing heart defects by recording the heart’s electrical activity. 
• Cardiac catheterization. This procedure is not only used to diagnose a PDA, but also to see other congenital heart defects. Cardiac catheterization can also be used to treat a PDA. 

Treatments for patent ductus arteriosus (PDA) this condition usually depend on the age of the patient. Treatment options include:

• Monitoring or watchful waiting: A PDA in a premature baby typically closes on its own. Close monitoring is needed to make sure the PDA closes properly. A small PDA on full-term babies, children, and adults may need monitoring for a certain period, as well. 
• Medications: NSAIDs or nonsteroidal anti-inflammatory drugs like ibuprofen and indomethacin are used to help close a PDA in premature babies. However, these drugs won’t close a PDA if the patient is a full-term baby, a child, or already an adult. 
• Open-heart surgery: If medications turn to be ineffective and if the condition is severe or causing other complications, your doctor may suggest an open heart surgery. 
• Catheter procedures: Catheter procedures are not suitable for premature babies, but can be used to treat older, full-term babies, as well as children and adults. 

While there are no sure ways in preventing patent ductus arteriosus (PDA) from taking place, it is vital to do what you can to maintain a healthy pregnancy:

• Seek early prenatal care. An early prenatal care is important, and can be done even before you get pregnant. Quit smoking and minimize stress if you are taking any medications, talk to your doctor about it before planning to get pregnant.  
• Eat a healthy diet. Eat a balanced diet and take folic acid supplements if you are planning to get pregnant. 
• Exercise regularly. Talk to your doctor about the exercise plan that fits you.
• Avoid risks and infections. Keep away from harmful substances like cigarettes, alcohol, and illegal drugs as well as saunas and hot tubs. Avoid infections, keep vaccinations updated. Several infections can harm a developing baby. 
• Keep diabetes in control. Talk with your doctor if you have a diabetes and planning to get pregnant.
• Ready your body. Make sure you and your body are ready before getting pregnant. If your family has a history of genetic disorders such as heart defects, consider discussing it first with your doctor before getting pregnant.

There are several risks and complications associated with patent ductus arteriosus (PDA).

The risk factors of developing a PDA include:

• Rubella infection during pregnancy
• Premature birth
• Family has a history of genetic conditions
• Being born at a high altitude

While a small PDA might not result in any complication, a large PDA might cause:

• Pulmonary hypertension
• Heart failure
• Heart infection
• Inflammation of the heart’s lining