Some children can have other heart defects along with the PDA. Normally the heart's left side only pumps blood to the body, and the right side only pumps blood to the lungs. In a child with PDA, extra blood gets pumped from the body artery aorta into the lung pulmonary arteries. If the PDA is large, the extra blood being pumped into the lung arteries makes the heart and lungs work harder and the lungs can become congested.
If the PDA is small, it won't cause symptoms because the heart and lungs don't have to work harder. The only abnormal finding may be a distinctive type of murmur noise heard with a stethoscope.
If the PDA is large, the child may breathe faster and harder than normal. Infants may have trouble feeding and growing at a normal rate. Symptoms may not occur until several weeks after birth. High pressure may occur in the blood vessels in the lungs because more blood than normal is being pumped there.
Over time this may cause permanent damage to the lung blood vessels. If the PDA ductus is small, it doesn't make the heart and lungs work harder.
Surgery and other treatments may not be needed. Small PDAs often close on their own within the first few months of life. Most children can have the PDA closed by inserting catheters long thin tubes into the blood vessels in the leg to reach the heart and the PDA, and a coil or other device can be inserted through the catheters into the PDA like a plug. The figure below on the left shows one example of how a catheterization is used to close the ductus. If surgery is needed, an incision is made in the left side of the chest, between the ribs.
The ductus is closed by tying it with suture thread-like material or by permanently placing a small metal clip around the ductus to squeeze it closed. If there's no other heart defect, this restores the child's circulation to normal. In premature newborn babies, medicine can often help the ductus close.
After the first few weeks of life, medicine won't work as well to close the ductus and surgery may be required. If the PDA is small, or if it has been closed with catheterization or surgery, your child may not need any special precautions regarding physical activity and may be able to participate in normal activities without increased risk. As far as follow up in the future, depending on the type of PDA closure, your child's pediatric cardiologist may examine it periodically to look for uncommon problems.
The long-term outlook is excellent, and usually no medicines and no additional surgery or catheterization are needed. Congenital Heart Defect ID sheet. Larger text size Large text size Regular text size.
What Is Patent Ductus Arteriosus? What Happens in Patent Ductus Arteriosus? What Causes Patent Ductus Arteriosus? Babies with a large PDA might have symptoms such as: a bounding strong and forceful pulse fast breathing not feeding well shortness of breath sweating while feeding tiring very easily poor growth How Is Patent Ductus Arteriosus Diagnosed? Follow-up tests might include: a chest X-ray an EKG , a test that measures the heart's electrical activity and can show if the heart is enlarged an echocardiogram, a test that uses sound waves to diagnose heart problems.
These waves bounce off parts of the heart, creating a picture of the heart. In babies with PDA, an echo shows how big the opening is and how well the heart is handling it. Patent ductus arteriosus PDA. The American Heart Association. Doyle T, et al. Clinical manifestations and diagnosis of patent ductus arteriosus in term infants, children, and adults. Merck Manual Professional Version. Waksmonski CA, et al. Pregnancy in women with congenital heart disease: General principles.
Riggin EA. Allscripts EPSi. Mayo Clinic. Planning for pregnancy. Centers for Disease Control and Prevention. Townsend CM Jr, et al. Congenital heart disease. Elsevier; Conrad C, et al. Understanding the pathophysiology, implications and treatment options of patents ductus arteriosus in the neonatal population.
Advances in Neonatal Care. Ferri FF. This blood vessel is called the ductus arteriosus 3. When it remains open after birth it is called a patent ductus arteriosus. Most of the rest will close during the first year of life. While the baby is in the womb, the fluid in the lungs causes high pressure so blood entering the pulmonary artery takes the path of least resistance bypassing the lungs and flowing out to the aorta through the ductus arteriosus.
After birth, the lungs fill with oxygen so the pressure in lungs and the pulmonary artery goes down. At the same time, the umbilical cord is clamped and the pressure in the aorta increases. As a result, the pressure in the pulmonary artery is lower than the pressure in the aorta so some of the blood in the aorta flows through the ductus back to the lungs. This results in extra blood flow to the lungs. If the ductus is small, the extra blood flow is minimal but if the ductus is large, there can be a large amount of blood returning to the lungs causing a significant increased workload for the heart.
The effects of patent ductus arteriosus relate largely to the size of the ductus. Babies born very prematurely are more sensitive to the extra pulmonary blood flow so are more likely to have heart related symptoms. If the extra blood flow taxes the heart too much, symptoms of congestive heart failure develop.
This is not uncommon in premature infants but is quite rare in full term infants or older children. Symptoms of congestive heart failure include rapid breathing, feeding problems, slow weight gain, low energy, and cold, clammy sweating. If the PDA remains large, over time the extra blood flow damages the pulmonary artery and they become stiff and thickened.
This condition, called pulmonary vascular disease is a very serious problem for which there is currently no effective treatment. Children with patent ductus arteriosus are also at increased risk for subacute bacterial endocarditis SBE. This is an infection of the heart caused by bacteria in the blood stream. It can occur after a dental or other medical procedure but can usually be prevented by a dose of antibiotic prior to the procedure.
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