Patent ductus arteriosus (PDA) is a common heart defect that occurs when the ductus arteriosis does not close shortly after birth. The ductus arteriosis is a fetal artery connecting the aorta and the pulmonary artery. When the artery is not closed properly, it acts as a detour by not sending all the blood to the lungs (fetal blood obtains oxygen from the placenta). After birth, oxygen poor blood needs to go to the lungs to obtain oxygen. If the ductus arteriosis does not close, it can cause both the lungs and the heart to work too hard. PDA is sometimes found with other heart defects or in certain genetic conditions such as Down syndrome. PDA appears to be more common in girls.
Usually PDA is diagnosed in infancy but if it is small, symptoms may only appear in childhood. Severity of symptoms depends on the size and whether other heart defects are also present. Symptoms may include poor feeding or sweating while feeding, shortness of breath, tiring easily, fast pulse and poor growth. The causes of PDA are likely a combination of genetics and environment. Risk factors include premature birth, being born at a high altitude, a rubella infection during pregnancy, or a family history of certain genetic conditions.
A heart murmur is usually heard in infancy, but may be missed in a premature baby. The diagnosis will be confirmed using X-rays and an electrocardiogram (EKG). Other tests may check for other possible heart defects. In premature babies, the opening may close on its own even after the first few days, so the PDA may just be watched. Treatment options include medication and surgery, and may not be necessary. Outlook is excellent if PDA occurs without any associated birth defects. Talk to your baby’s cardiologist about treatment and management options. If the PDA is part of a syndrome or runs in your family, talk to a genetic counselor. Support groups are a good source of information and can connect you to other families affected by PDA.