Learn about symptoms, causes and treatment of this common — and treatable — heart problem that occurs shortly after birth.
Patent ductus arteriosus (PDA) is a persistent opening between the two major blood vessels leading from the heart. The heart problem is present from birth. That means it is a congenital heart defect.
An opening called the ductus arteriosus is part of a baby's blood flow system in the womb. It usually closes shortly after birth. If it remains open, it's called a patent ductus arteriosus.
A small patent ductus arteriosus often doesn't cause problems and might never need treatment. However, a large, untreated patent ductus arteriosus can let oxygen-poor blood move the wrong way. This can weaken the heart muscle, causing heart failure and other complications.
Treatment options for a patent ductus arteriosus include regular health checkups, medicines, and a procedure or surgery to close the opening.
Patent ductus arteriosus is a persistent opening between the two main blood vessels leaving the heart. Those vessels are the aorta and the pulmonary artery. The condition is present at birth.
Patent ductus arteriosus symptoms (PDA) depend on the size of the opening and the person's age. A small PDA might not cause symptoms. Some people don't notice symptoms until adulthood. A large PDA can cause symptoms of heart failure soon after birth.
A large PDA found during infancy or childhood might cause:
Contact the doctor if your baby or older child:
The exact causes of congenital heart defects are unclear. During the first six weeks of pregnancy, a baby's heart starts to form and beat. The major blood vessels to and from the heart grow. It's during this time that certain heart defects may begin to develop.
Before birth, a temporary opening called the ductus arteriosus is between the two main blood vessels leaving a baby's heart. Those vessels are the aorta and the pulmonary artery. The opening is necessary for a baby's blood flow before birth. It moves blood away from a baby's lungs while they develop. The baby gets 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 infants, the opening doesn't close. When it stays open, it's called a patent ductus arteriosus.
The persistent opening causes too much blood to flow to the baby's lungs and heart. Untreated, the blood pressure in the baby's lungs might increase. The baby's heart might grow larger and get weak.
Risk factors for patent ductus arteriosus (PDA) include:
A small patent ductus arteriosus might not cause complications. Larger, untreated defects could cause:
It may be possible to have a successful pregnancy with a small patent ductus arteriosus. However, having a large PDA or complications such as heart failure, irregular heartbeats or lung damage increases the risk of serious complications during pregnancy.
Before becoming pregnant, talk to your health care provider about possible pregnancy risks and complications. Some heart medicines can cause serious problems for a developing baby. Your health care provider may stop or change your medicines before you become pregnant.
Together you can discuss and plan for any special care needed during pregnancy. If you are at high risk of having a baby with a heart problem present at birth, genetic testing and screening may be done during pregnancy.
There is no known prevention for patent ductus arteriosus. However, it's important to do everything possible to have a healthy pregnancy. Here are some of the basics:
The health care provider does a physical exam and asks questions about your medical history. The care provider may hear a heart sound called a murmur while listening to the heart with a stethoscope.
Tests that may be done to diagnose patent ductus arteriosus include:
Treatments for a patent ductus arteriosus depend on the age of the person being treated. Some people with small PDAs that aren't causing problems only need regular health checkups to watch for complications. If a premature baby has a PDA, the health care provider does regular checkups to make sure it closes.
Medicines called nonsteroidal anti-inflammatory drugs (NSAIDs) may be given to premature babies to treat a PDA. These medicines block certain body chemicals that keep a PDA open. However, these medicines won't close a PDA in full-term babies, children or adults.
In the past, health care providers told people born with a PDA to take antibiotics before dental work and certain surgical procedures to prevent certain heart infections. This is no longer recommended for most people with a patent ductus arteriosus. Ask your health care provider if preventive antibiotics are necessary. They might be recommended after certain heart procedures.
Advanced treatments to close a patent ductus arteriosus include:
Using 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 repair to be done without open-heart surgery.
During a catheter procedure, the health care provider inserts a thin tube into a blood vessel in the groin and guides it to the heart. A plug or coil passes through the catheter. The plug or coil closes the ductus arteriosus. The treatment doesn't usually require an overnight hospital stay.
Premature babies are too small for catheter treatments. If the PDA isn't causing problems, a catheter treatment to close the opening may be done when the baby is older.
Open-heart surgery to close the PDA. This treatment is called surgical closure. Heart surgery may be needed if medicine doesn't work or the PDA is large or causing complications.
A surgeon makes a small cut between the ribs to reach the child's heart. The opening is closed using stitches or clips. It usually takes a few weeks for a child to fully recover from this surgery.
Some people born with a PDA need regular health checkups for life, even after treatment to close the opening. During these checkups, the health care provider may run tests to check for complications. Talk to your health care provider about your care plan. Ideally, it's best to seek care from a provider trained in treating adults with heart problems before birth. This type of provider is called a congenital cardiologist.
Anyone born with a patent ductus arteriosus needs to take steps to keep the heart healthy and prevent complications. These tips can help:
A large patent ductus arteriosus or one that's causing serious health problems may be diagnosed immediately at birth. But some smaller ones might not be noticed until later in life. If you have a PDA, you may be referred to a health care provider trained in heart problems present at birth. This type of provider is called a congenital cardiologist. A provider with training in kids' heart conditions is called a pediatric cardiologist.
Here's some information to help you get ready for your appointment.
For patent ductus arteriosus, questions to ask include:
Don't hesitate to ask other questions, as well.
The doctor is likely to ask you a number of questions, such as: