Patent Ductus Arteriosus

What is Patent Ductus Arteriosus

Patent ductus arteriosus is a problem with a blood vessel that connects two arteries in the heart (ductus arteriosus). The ductus arteriosus connects the artery that leads to the lungs (pulmonary artery) and the main artery that leads to the body (aorta).

Normally, the ductus arteriosus closes after birth, because the connection between the pulmonary artery and the aorta is no longer needed. When the ductus arteriosus does not close soon after birth, it is called an open (patent) ductus arteriosus.

Patent ductus arteriosus does not always cause problems, especially if the opening is very small. However, it may cause:

  • Extra blood flow to the lungs.
  • Enlargement of the left side of the heart.
  • Increased blood pressure in the lungs.
  • Strain on the heart.
  • Heart failure, infection, or other heart problems, if it is not treated.

What are the causes?

The cause of this condition is not known.

What increases the risk?

This condition is more likely to develop in babies who:

  • Are born early (prematurely).
  • Are born at a high altitude.
  • Have certain genetic conditions, such as Down syndrome.
  • Are girls.

What are the signs or symptoms?

Most children with this condition do not have symptoms. If symptoms are present, they may include:

  • Fast breathing or difficult breathing.
  • Feeding problems.
  • Poor weight gain.
  • Low energy (listlessness).
  • Tiring easily.
  • Feeling cold, clammy, and sweaty.

How is this diagnosed?

This condition may be diagnosed based on:

  • A physical exam. This includes listening to your child’s heartbeat for any unusual sounds (heart murmur).
  • Tests, such as:
    • Chest X-ray.
    • Echocardiogram. This test produces images of the heart using sound waves.
    • Electrocardiogram (ECG). This test records the electrical activity of the heart.

Your child may be referred to a health care provider who specializes in the heart (cardiologist) or in children’s health (pediatrician).

How is this treated?

In some cases, the patent ductus arteriosus may close on its own, and treatment may not be needed. If the ductus arteriosus does not close on its own, or if it is causing serious problems, treatment may be needed. Your child’s health care provider will decide which treatment is best for your child based on factors such as age, weight, symptoms, and the shape of the patent ductus arteriosus. If needed, treatment may include:

  • NSAIDs, if your child was born early (prematurely). NSAIDs help the ductus arteriosus to close.
  • Surgery. This is done by making a large incision in the chest and closing the patent ductus arteriosus with stitches (sutures) or a clip.
  • Transcatheter closure. This is a procedure in which a thin, flexible tube (catheter) is used to place a closure device in the blood vessel.

Follow these instructions at home:

Medicines

  • Give over-the-counter and prescription medicines only as told by your child’s health care provider.
  • Do not give your child aspirin because of the association with Reye syndrome. Give this medicine only if instructed to do so by your child’s health care provider.
  • If your child was prescribed an antibiotic medicine, give it to him or her as told by your health care provider. Do not stop giving your child the antibiotic even if he or she starts to feel better.

General instructions

  • Tell all health care providers who care for your child (including dentists) about your child’s condition.
  • Make sure to brush and floss your child’s teeth regularly. (Have your child do this himself or herself if your child is old enough to do so.) This helps to prevent infection.
  • Schedule regular dental checkups for your child.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

  • Your child coughs more than usual.
  • Your child’s symptoms get worse or new symptoms develop.
  • Your child is not gaining weight or is gaining weight very slowly.
  • Your child gets tired very easily when eating or crying.

Get help right away if:

  • Your child has difficulty breathing or is breathing rapidly.
  • Your child is not acting normally.
  • Your child is listless.
  • Your child has a fever.
  • Your child has feeding problems.
  • Your child is cold, clammy, and sweaty.

Summary

  • When a blood vessel that connects two arteries in the heart (ductus arteriosus) does not close soon after birth, it is called an open (patent) ductus arteriosus.
  • Patent ductus arteriosus does not always cause problems, especially if the opening is very small. However, it may cause strain on the heart, especially in premature infants.
  • Surgery may be needed to treat the condition.
  • Tell all health care providers who care for your child (including dentists) about your child’s condition.
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