Description

Patent ductus arteriosus (PDA) is a persistent opening between two major blood vessels that carry blood from the heart.

An opening, called the ductus arteriosus is part of the flow of blood in the womb to an unborn baby, it is also called a fetus. It usually closes shortly after birth. If the opening remains open, it is called a patent ductus arteriosus. A PDA is a type of congenital heart defect.

A small PDA may not need treatment. But a large, without treatment of patent ductus arteriosus you can leave the oxygen-poor blood move it the wrong way. This can cause the heart muscle is weak, causing heart failure and other complications.

Treatment of patent ductus arteriosus may include regular health checkups, medication, procedure, or surgery to close the opening.

Symptoms

Patent ductus arteriosus symptoms (PDA) depend on the size of the opening and the age of the person. A small PDA may not cause symptoms. Some people don't notice the symptoms until adulthood. A large PDA may cause symptoms of heart failure immediately after birth.

A great PDA found during infancy or childhood can cause:

  • Good to eat, which leads to poor growth.
  • Sweating with the crying or eating.
  • Constant rapid breathing or shortness of breath.
  • Easy to strenuous.
  • Rapid heart rate.

When to see a doctor

Contact a healthcare provider if your baby or older child:

  • You get tired easily when eating or playing.
  • Is not gaining weight.
  • It becomes out of breath when eating or crying.
  • Always breathe faster, or is lack of air.

Causes

The exact causes of the persistence of the ductus arteriosus and other birth defects of the heart are not clear. During the first six weeks of pregnancy, an unborn baby's heart begins to form and rhythm. The main blood vessels and the heart to grow. It is during this time that certain birth defects of the heart may begin to develop.

Before birth, there is a temporary opening, called the ductus arteriosus between the two main blood vessels leaving the heart of a baby. The blood vessels are the aorta and the pulmonary artery. The opening is needed for a baby's blood flow before birth. The blood moves from the lungs of a baby while develop. The baby receives oxygen from the mother's blood.

After birth, the ductus arteriosus is no longer needed. It usually closes within 2 to 3 days. But in some babies, the opening does not close. When it is kept open, it is called a patent ductus arteriosus.

The constant opening of the cause too much blood to flow to the baby's lungs and the heart. Without treatment, the blood pressure in the baby's lungs may increase. The heart of the baby can grow more and weaken.

Risk factors

Risk factors for the persistence of the ductus arteriosus (PDA) include:

  • The preterm birth. Patent ductus arteriosus occurs more commonly in babies who are born too early in infants born full-term.
  • The history of the family and other genetic conditions. A family history of heart disease present from birth, may increase the risk of PDA . Babies are born with an extra chromosome 21, a condition called Down syndrome, are also more likely to have persistence of the ductus arteriosus.
  • Rubella during pregnancy. Having German measles, also called the rubella during pregnancy can cause changes in the heart of the unborn baby. A blood test before pregnancy can know if you are immune to rubella. A vaccine is available for those who are not immune.
  • Having been born in altitude. Babies born above 8,200 feet (2,499 meters) have an increased risk of PDA that babies born at lower altitudes.
  • Female sex assigned at birth. Patent Ductus arteriosus is two times more common in girls.

Complications

A small patent ductus arteriosus may not cause complications. Larger, untreated Pda could cause:

  • High blood pressure in the lungs, also called pulmonary hypertension. A great PDA causes irregular blood flow in the heart and the lungs. As a result, the pressure rises in the pulmonary artery. Over time, the increased pressure damages the small blood vessels in the lungs. To put in danger the life and durable type of lung damage called Eisenmenger syndrome may occur.
  • Heart failure. The symptoms of this serious complication include rapid breathing, often with gasping breaths, and poor weight gain.
  • Heart infection called endocarditis. Patent ductus arteriosus may increase the risk of germs from attaching to the areas in the heart. Without rapid treatment, endocarditis can damage or destroy heart valves.

Persistence of the ductus arteriosus and pregnancy

It is possible to have a successful pregnancy with a small patent ductus arteriosus. However, having a large PDA or a complication such as heart failure, lung damage or irregular beats of the heart, increases the risk of serious complications during pregnancy.

Before getting pregnant, talk with your healthcare provider about the possible risks of pregnancy and complications. Some heart medications can be dangerous to an unborn baby. Your healthcare provider may stop or change your medication before you get pregnant.

Together, you can plan for any special care during pregnancy. If you are at high risk of having a baby with a heart condition present from birth, genetic testing and screening can be done during pregnancy.

Prevention

There is no known way to prevent the persistence of the ductus arteriosus. However, it is important to do everything you can to have a healthy pregnancy. Here are some of the basic concepts:

  • Get early prenatal care, even before you're pregnant. If you are thinking about pregnancy, talk with your health care team to develop a plan for prenatal care. Also tell your health care professional about all the medicines you are taking, including those bought without a prescription.
  • Start taking folic acid. Take 400 micrograms of folic acid every day before and during pregnancy has been shown to reduce the brain and spinal cord conditions in the baby. It can also help to reduce the risk of heart disease.
  • Exercise and stay active. Work with your health care professional to develop an exercise plan that is right for you.
  • Do not drink alcohol or smoke. These lifestyle habits can affect the health of the baby. Also avoid second-hand smoke.
  • Get the recommended vaccines. Update your vaccines before you get pregnant. Certain types of infections can be detrimental to the development of your baby.
  • The Control of sugar in the blood. If you have diabetes, good control of your blood sugar can reduce the risk of certain diseases of the heart that are present at the birth of your baby.

Diagnosis

To diagnose patent ductus arteriosus (PDA), a health care professional performs a physical exam and ask questions about you or your child's medical history. The health care provider may hear a heart sound is called a murmur while listening to the heart with a stethoscope.

Tests

The tests can help to diagnose the persistence of the ductus arteriosus.

  • The echocardiogram. The sound waves to make pictures of the heartbeat. This test shows how the blood flows through the heart and the heart valves. You can say, if there is a persistent opening in the heart. An echocardiogram can also indicate if there are higher pressures in the arteries of the lung.
  • X-ray of the chest. This test shows the condition of the heart and the lungs.
  • Electrocardiogram (ECG or EKG). This quick and simple test records the electrical signals that make the heart beat. It shows how fast or slow the heart is beating.
  • The cardiac catheterization. This test is usually not necessary to diagnose the persistence of the ductus arteriosus. But it could be done if there are other heart conditions. A doctor places a thin, flexible tube called a catheter into a blood vessel, usually in the groin or the wrist, and the guide for the heart. During this test, the treatments can be done to close the patent ductus arteriosus.

Treatment

Treatment of patent ductus arteriosus (PDA) depend on the age of the person being treated.

Some people with small Pda may only need regular medical checkups to monitor complications. A premature baby born with patent ductus arteriosus, also need regular checkups to make sure that the opening is closed.

Drugs

A premature baby born with patent ductus arteriosus (PDA) can get medications called nonsteroidal anti-inflammatory drugs. These drugs, also called Nsaids, blocking certain chemicals in the body that keep the PDA open. However, these drugs can not close a PDA in full-term babies, children or adults.

In the past, health professionals told the people that was born with patent ductus arteriosus to take antibiotics to prevent infection before the dental work and some surgeries. This is not recommended for most people with persistence of the ductus arteriosus. Ask your health care professional if the use of preventive antibiotics are necessary. That might be recommended after certain heart procedures.

Surgery or other procedures

Treatments to close a patent ductus arteriosus include:

  • The use of a thin tube, called catheterand a plug or coil to close the opening. This treatment is called a catheter procedure. It allows a doctor to repair the opening without open-heart surgery. To make this treatment, the doctor places the catheter in a blood vessel in the groin and the guide for the heart. A plug or coil passes through the catheter. The plug or the coil closes the patent ductus arteriosus. The treatment does not usually require an overnight stay in the hospital. Premature babies are too small for the placement of the catheter treatments. If thePDAisn not causing problems, a catheter treatment to close the opening can be done when the baby is older.
  • Open heart surgeryto near thePDA. This treatment is called the surgical closure. May be necessary if the medicine is not working or if thePDAis large or cause complications. The surgeon makes a small incision between the ribs to reach the heart. ThePDAis closed with stitches or staples. It usually takes a few weeks to fully recover from this surgery.

The use of a thin tube, called a catheter , and a plug or coil to close the opening. This treatment is called a catheter procedure. It allows a doctor to repair the opening without open-heart surgery.

To make this treatment, the doctor places the catheter in a blood vessel in the groin and the guide for the heart. A plug or coil passes through the catheter. The plug or the coil closes the patent ductus arteriosus. The treatment does not usually require an overnight stay in the hospital.

Premature babies are too small for the placement of the catheter treatments. If the PDA is not causing problems, a catheter treatment to close the opening can be done when the baby is older.

Open-heart surgery to close the PDA . This treatment is called the surgical closure. May be necessary if the medicine is not working or if the PDA is large or causing complications.

The surgeon makes a small incision between the ribs to reach the heart. The PDA is closed with stitches or staples. It usually takes a few weeks to fully recover from this surgery.

Some people are born with the PDA's need for regular health examinations for life, even after treatment to close the opening. During these visits, a health care provider may do tests to check you for complications. Talk with your healthcare provider about your plan of care. Ideally, it is best to seek care from a medical doctor trained in the treatment of adults with conditions of the heart before birth. This type of doctor is called a congenital cardiologist.

Lifestyle and home remedies

Anyone born with a patent ductus arteriosus needs to take steps to keep the heart healthy and prevent complications. These tips can help.

  • Do not smoke. Smoking is a major risk factor for heart disease and other heart conditions. Quitting smoking is the best way of reducing the risk. If you need help quitting, talk to your health professional.
  • Eat healthy foods. Eat plenty of fruits, vegetables and whole grains. Limit the amount of sugar, salt and saturated fat.
  • Practice good hygiene. Regularly washing hands and brushing and flossing your teeth to stay healthy.
  • Ask them about the sports of limits. Some people are born with heart conditions may be told not to do some type of exercise or sports activities. Ask your health care professional sports and types of exercise are safe for you or your child.
  • Manage stress. Find ways to help reduce emotional stress. The following are some tips for doing more exercise, practice mindfulness and connecting with others in support groups. If you have anxiety or depression, talk to your health professional about treatments that can help.

Preparing for your appointment

A large patent ductus arteriosus, or one that is causing serious health problems can be diagnosed immediately after birth. But some smaller ones may not be found until later in life. If you have a PDA , you may be referred to a doctor trained in heart disease present at birth. This type of doctor is called a congenital cardiologist. A physician with training in children diseases of the heart is called a pediatric cardiologist.

Here's some information to help you prepare for your appointment.

What you can do

  • Be aware of the restrictions before the appointment. When you make the appointment, ask if there is something that you need to do in advance, such as not eating or drinking before certain tests.
  • Make a note of the symptoms, including those that may not appear to be related to the patent ductus arteriosus or other heart disease.
  • Write important personal information, including any family history of heart disease.
  • Bring copies of recent medical records, including reports of previous treatments, or tests.
  • Make a list of all the medicines, vitamins, and supplements that you or your child need. Include the dose.
  • Bring someone along, if possible. Someone who goes with you can help you remember the information they give you.
  • Write down questions to ask the health professionals.

Due to persistence of the ductus arteriosus, questions include:

  • Is the PDA causing complications?
  • What tests are needed?
  • Will I or my child need surgery?
  • Should I or my child see a doctor trained in congenital heart defects?
  • Is this an inherited condition? If I have other children, what are the chances that have PDA ?
  • I need to limit my or my child's activities?
  • Is there any information that I can take my house? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

The health professional is likely to ask many questions, such as:

  • When he noticed the symptoms?
  • The symptoms are always there or come and go?
  • How bad are the symptoms?
  • What, if anything, makes the symptoms better?
  • What, if anything, makes the symptoms worse?
  • What are the medicines that you or your child are taking to treat the disease? What surgeries have you or your child has had?
Symptoms and treatment of patent ductus arteriosus (PDA)