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Patent ductus arteriosus (PDA) is a heart defect found in the days or weeks after birth. The ductus arteriosus is a normal part of fetal blood circulation. All babies are born with this opening between the aorta and the pulmonary artery. But it usually closes on its own shortly after birth. If it stays open, it is called patent ductus arteriosus. With PDA, extra blood flows to the lungs. The blood vessels and the lungs have to work much harder to handle the extra blood.
PDA occurs twice as often in girls as in boys.
The size of the opening between the aorta and the pulmonary artery will affect symptoms. If your baby has a small opening, he or she may not have symptoms. If your baby has a larger opening, he or she may have symptoms. The following are the most common symptoms of PDA:
The symptoms of PDA can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
The healthcare provider will ask about your baby’s symptoms and health history. He or she will give your baby a physical exam. The provider may have heard a heart murmur or or found other symptoms during an exam. The provider may refer your baby to a pediatric cardiologist. This is a doctor with special training to diagnose and treat heart problems in children.
The cardiologist will also examine your baby, and listen to his or her heart and lungs. The details about the heart murmur will help the provider make the diagnosis. Your baby may need tests, such as:
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
A small patent ductus arteriosus may close on its own as your child grows. A PDA that causes symptoms will need to be treated with medicine or surgery. The cardiologist will check periodically to see whether the PDA is closing on its own. If a PDA does not close, it will be fixed to prevent lung problems. Treatment may include the following.
Your baby may need medicines help the heart work better.
Most infants with PDA eat and grow normally. Some premature infants or those infants with large PDAs may become tired when feeding. They may not be able to eat enough to gain weight. Nutrition choices include:
Surgery can repair or close PDAs. Repair is usually advised for babies younger than 6 months of age who have large defects and who have symptoms such as poor weight gain and fast breathing. For babies who do not have symptoms, any repairs may be delayed until after 6 to 12 months of age. Your child's cardiologist will recommend when the repair should be done. Procedures include:
If your baby is able to be discharged home before having a repair procedure, you will be shown how to feed and give medicine to your baby. You will also be taught about what symptoms to report to your child's healthcare provider.
When your child is discharged after the PDA repair, you may give pain medicine such as acetaminophen or ibuprofen to keep your child comfortable. Your child's cardiac team will discuss pain control before your child goes home.
Often infants who fed poorly before surgery have more energy once they recover. They begin to eat better and gain weight faster.
Within a few weeks after surgery, older children are usually fully recovered and able to do normal activities.
You will get other instructions from your child's cardiac team and the hospital staff.
In premature infants, the outlook after PDA surgical repair depends on gestational age and overall health.
In children born full-term, early diagnosis and repair of PDA lets them live normal, healthy lives. Activity levels, appetite, and growth should return to normal. Your child's cardiologist may recommend that your child take antibiotics to prevent infection in the heart lining and valves (bacterial endocarditis).
In children with large PDAs diagnosed very late or never repaired, the outlook is uncertain. They are at risk for increased blood pressure in the blood vessels of the lungs (pulmonary hypertension). These children should get follow-up at a care center that specializes in congenital heart disease.
Talk with your child's cardiologist about your child’s outlook.
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.