Patent Ductus Arteriosus (PDA)

In most babies who have an otherwise normal heart, the ductus arteriosus will shrink and close on its own in the first few days of life. If it stays open longer, it may cause extra blood to flow to the lungs. When it doesn’t close as normal, the condition is known as a patent ductus arteriosus.

Problems can happen if the patent ductus arteriosus is large causing a large amount of blood to flow to the lungs. When a smaller patent ductus arteriosus is present, it is possible that it may close on its own by a child’s first birthday.

A patent ductus arteriosus is more likely to stay open in a premature infant, particularly if the baby has lung disease. When this happens, doctors might need to close the patent ductus arteriosus with medicines or surgically.

The specialists at Norton Children’s Heart Institute — the leading provider of pediatric heart care in Louisville and Southern Indiana — can help your child with a patent ductus arteriosus.

The board-certified and fellowship-trained specialists at Norton Children’s Heart Institute, affiliated with the University of Louisville, have the skill and experience to provide a precise diagnosis and determine whether a patent ductus arteriosus will close on its own, close with medications, or whether surgery is needed.

The Society of Thoracic Surgeons has ranked Norton Children’s Heart Institute’s pediatric heart care among the best in the region. Norton Children’s has a network of outreach diagnostic and treatment services throughout Kentucky and Southern Indiana.

An illustration shows a child's heart with patent ductus arteriosis

The Effects of a Patent Ductus Arteriosus

While a developing baby is in the womb, the baby gets oxygen directly from the mother’s placenta. The ductus arteriosus bypasses the lungs to send blood directly to the body. When a newborn breathes and begins to use the lungs, the ductus is no longer needed and usually closes by itself during the first two days after birth.

When it stays open, the patent ductus arteriosus allows blood from the aorta to flow into the pulmonary artery. As a result, too much blood flows into the lungs, which puts a strain on the heart and increases blood pressure in the pulmonary arteries.

In infants born with other congenital heart conditions with decreased blood flow from the heart to the lungs or decreased flow of oxygen-rich blood to the body, the patent ductus arteriosus may actually help, and the doctor might prescribe medicine to keep the ductus arteriosus open.

A persistent patent ductus arteriosus is more common in premature babies and affects twice as many girls as boys. It is also common among babies with neonatal respiratory distress syndrome, babies with genetic disorders (such as Down syndrome) and babies whose mothers had rubella (also called German measles) during pregnancy.

Patent Ductus Arteriosus Symptoms

Babies with a large patent ductus arteriosus might have symptoms such as:

  • A strong and forceful pulse
  • Fast breathing
  • Not feeding well
  • Poor growth
  • Shortness of breath
  • Sweating while feeding
  • Tiring very easily

Diagnosing Patent Ductus Arteriosus

Your child’s doctor will listen for a heart murmur if a patent ductus arteriosus is suspected.

Follow-up tests might include a chest X-ray, an electrocardiogram (EKG) to measures the heart’s electrical activity, an echocardiogram that uses sound waves to diagnose heart conditions and blood tests. Other tests performed may include:

  • CT angiography: uses a CT scanner to produce detailed images of the blood vessels following a dye injection.
  • Chest X-ray: This shows pictures of the heart and lungs, and can show heart and lung issues, including extra blood flow or fluid in the lungs.
  • Echocardiogram (echo): This test uses sound waves (ultrasound) to produce images of the heart and blood vessels’ structures on a screen. It can show structure of the heart and ductus arteriosus and also the function of the heart. Norton Children’s Heart Institute has 28 tele-echo locations throughout Kentucky and Southern Indiana.
  • Electrocardiogram (ECG or EKG): A test that checks the heart’s electrical activity to show damage or irregular rhythms.
  • Heart catheterization: This invasive procedure studies the structure, function, and provides direct pressure measurements of the heart and large blood vessels.

Patent Ductus Arteriosus Treatment

Three treatment options for patent ductus arteriosus are:

  • Medication
  • Pediatric catheterization procedure to repair
  • Surgery to repair

A doctor will close a patent ductus arteriosus if the size of the opening is big enough that the lungs are becoming overloaded with blood, a condition that can lead to congestive heart failure and pulmonary hypertension.

A doctor also may close a patent ductus arteriosus to reduce the risk of developing a heart infection called endocarditis, which affects the tissue lining the heart and blood vessels. Endocarditis is serious and requires treatment with intravenous (IV) antibiotics.

Why Norton Children’s Heart Institute?

Norton Children’s Heart Institute, affiliated with the University of Louisville, is a comprehensive pediatric heart surgery, heart failure and heart transplant program serving Kentucky, Southern Indiana and beyond.

The goal of the full-service Norton Children’s Heart Institute is to provide care for the child and the whole family. Our specialists are prepared to repair even the most complex congenital and acquired heart conditions.

Our heart team includes:

  • Pediatric cardiothoracic surgeons
  • Pediatric transplant surgeons
  • Pediatric cardiologists
    • Fetal cardiologists
    • Adult congenital heart cardiologists
    • Heart failure/heart transplant cardiologists
    • Pediatric electrophysiologists
    • Pediatric cardiac catheterization cardiologists
  • Pediatric cardiovascular anesthesiologists
  • Pediatric intensive care physicians
  • Cardiac critical care nurses
  • Critical care pharmacists
  • Family support team
  • Child life specialists
  • Rehabilitation specialists
  • Social workers
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