Causative & risk factors
Premature birth or a genetic defect can lead to a patent ductus arteriosus. It can occur in connection with other congenital heart defects. Infection with rubella during pregnancy is associated with a risk of the baby developing patent ductus arteriosus.
Clinical presentation
Presence of a patent ductus arteriosus causes an excessive amount of blood to be pumped from the heart into the lungs, thus overworking both organs. This gives rise to a number of cardiac and respiratory symptoms. The child loses breath easily, even after mild exertion. Babies may become breathless and sweat profusely while feeding. Thus they tend to feed poorly and hence their growth is affected. The patient tires very easily and starts breathing rapidly. The pulse may become rapid (tachycardia) and bounding. Cyanosis may be present. Eventually cardiac enlargement may occur.
Investigations
On physical examination, a heart murmur may be heard. Basic cardiac investigations such as a chest X-ray, an ECG and an echocardiogram are carried out.
These can be followed up with specialized investigations such as a cardiac CT or MRI scan and cardiac catheterization.
Treatment
If PDA is diagnosed in a premature infant, certain medications especially nonsteroidal anti-inflammatory drugs will help to close the opening.
A small patent ductus arteriosus only needs to be monitored, since they can close automatically in the first few months of life.
If the PDA fails to close by itself, it can be closed by cardiac catheterization or an open heart surgery.
