Overview
Patent ductus arteriosus (PDA) is a congenital heart defect in which there is a persistent opening between the two major blood vessels leading from the heart. This opening, called the ductus arteriosus, is part of a baby's blood flow system in the womb. In most cases, it should close shortly after birth. However, if it remains open, it is referred to as a patent ductus arteriosus. The size of the PDA can vary, with some being small and causing no problems, while others can be large and lead to complications. Common symptoms of a large PDA may include poor eating and growth, sweating with crying or eating, persistent fast breathing or breathlessness, easy tiring, and a rapid heart rate. Treatment options may include regular health checkups, medicines, and a procedure or surgery to close the opening.
Understanding the disease
Symptoms
Symptoms of patent ductus arteriosus (PDA) can vary depending on the size of the opening and the person's age. In infants and children, symptoms may include poor eating leading to poor growth, sweating with crying or eating, persistent fast breathing or breathlessness, easy tiring, and rapid heart rate. It's important to contact a doctor if a baby or older child tires easily when eating or playing, isn't gaining weight, becomes breathless when eating or crying, or always breathes rapidly or is short of breath.
Risk Factors
Risk factors for developing patent ductus arteriosus (PDA) include:
- Premature birth: Patent ductus arteriosus 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 problems present at birth may increase the risk for a PDA. Babies born with an extra 21st chromosome, a condition called Down syndrome, also are more likely to have this condition.
- German measles during pregnancy: Having German measles, also called rubella, during pregnancy can cause problems in a baby's heart development. A blood test done before pregnancy can determine if you're immune to rubella. A vaccine is available for those who aren't immune.
Development
The various patent ductus arteriosus (PDA) develop due to a persistent opening between the two major blood vessels leading from the heart. This heart problem is present from birth, making it a congenital heart defect. The ductus arteriosus is a normal part of a baby's blood flow system in the womb, but it usually closes shortly after birth. If it remains open, it is called a patent ductus arteriosus. Patent ductus arteriosus can develop in different ways:
- Small PDA: A small PDA might not cause any problems and may never require treatment.
- Large PDA: A large PDA can lead to complications such as heart failure, high blood pressure in the lungs, and subaortic stenosis.
- PDA with other heart defects: Some people are born with other heart defects like atrial or ventricular septal defects, which can be associated with a PDA. The development of a PDA depends on various factors, such as genetics and environmental factors like being born at high altitude or being female. A PDA can cause symptoms like poor growth, sweating with crying or eating, rapid breathing, and tiring easily. It is essential to consult a doctor if you notice any of these symptoms in your baby or older child.
Assessment and Diagnosis
Triage
You should see a doctor if your baby or older child shows symptoms such as tiring easily when eating or playing, not gaining weight, becoming breathless when eating or crying, or always breathing rapidly or being short of breath.
Diagnosis
The primary methods for diagnosing patent ductus arteriosus include a physical examination by a healthcare provider, listening for a heart murmur using a stethoscope, and conducting various diagnostic tests such as echocardiogram, chest X-ray, and electrocardiogram. In some cases, cardiac catheterization may also be performed.
Management and Treatment
Complications
Potential complications of patent ductus arteriosus (PDA) include high blood pressure in the lungs (pulmonary hypertension), irregular blood flow in the heart and lungs, heart failure, and damage to blood vessels in the lungs leading to a life-threatening and permanent lung damage called Eisenmenger syndrome. Untreated PDA can lead to these complications over time. Treatment options include regular health checkups, medicines, and a procedure or surgery to close the opening in the blood vessels.
Treatment
Treatments for patent ductus arteriosus (PDA) include regular health checkups, medicines, and a procedure or surgery to close the opening. In some cases, a small PDA might not require any treatment, but a large, untreated PDA can lead to complications like heart failure and high blood pressure in the lungs (pulmonary hypertension). Treatment options depend on the size of the PDA, associated symptoms, and the patient's age and overall health.
Preparing for medical consultation
To prepare for an appointment for patent ductus arteriosus, you should:
- Be aware of pre-appointment restrictions: When you make the appointment, ask if there's anything you need to do in advance, such as avoid eating or drinking before certain tests.
- Write down symptoms: Include any symptoms that might seem unrelated to patent ductus arteriosus or another heart problem.
- Note important personal information: Include family history of heart problems.
- Bring copies of past medical records: Include reports from previous surgeries or imaging tests.
- List medications and supplements: Include the dosages of all medications, vitamins, or supplements you or your child takes.
- Take someone along: Having a companion can help you remember information you're given during the appointment.
- Write down questions: Prepare a list of questions to ask the health care provider, such as whether the PDA is causing problems, what tests are necessary, and if surgery is required.
- Note key personal information: Include previous piercing injuries or a family history of arteriovenous fistulas or other blood vessel diseases.
- Make a list of medications and supplements: Include the dosages of all medications, vitamins, or supplements you're taking.
- Bring a family member or friend: Having someone with you can help recall important information.
- Write down questions: Prepare a list of questions to ask your health care provider about your arteriovenous fistula, such as the cause of your symptoms, recommended tests, and available treatments. Remember that it's essential to be open and honest with your health care provider about your concerns, symptoms, and medical history to ensure the best possible care.