What is the significance of the ductus arteriosus

An unclosed hole in the aorta. Before a baby is born, the fetus's blood does not need to go to the lungs to get oxygenated. The ductus arteriosus is a hole that allows the blood to skip the circulation to the lungs.

However, when the baby is born, the blood must receive oxygen in the lungs and this hole is supposed to close. If the ductus arteriosus is still open or patent the blood may skip this necessary step of circulation. The open hole is called the patent ductus arteriosus. The ductus arteriosus is a normal fetal artery connecting the main body artery aorta and the main lung artery pulmonary artery. The ductus allows blood to detour away from the lungs before birth.

Every baby is born with a ductus arteriosus. After birth, the opening is no longer needed and it usually narrows and closes within the first few days.

Sometimes, the ductus doesn't close after birth. Failure of the ductus to close is common in premature infants but rare in full-term babies. In most children, the cause of PDA isn't known. Some children can have other heart defects along with the PDA. Normally the heart's left side only pumps blood to the body, and the right side only pumps blood to the lungs. In a child with PDA, extra blood gets pumped from the body artery aorta into the lung pulmonary arteries.

If the PDA is large, the extra blood being pumped into the lung arteries makes the heart and lungs work harder and the lungs can become congested. If the PDA is small, it won't cause symptoms because the heart and lungs don't have to work harder. The only abnormal finding may be a distinctive type of murmur noise heard with a stethoscope.

If the PDA is large, the child may breathe faster and harder than normal. Infants may have trouble feeding and growing at a normal rate.

Symptoms may not occur until several weeks after birth. High pressure may occur in the blood vessels in the lungs because more blood than normal is being pumped there. Over time this may cause permanent damage to the lung blood vessels. If the PDA ductus is small, it doesn't make the heart and lungs work harder.

Endocarditis is serious and requires treatment with intravenous IV antibiotics. Reviewed by: Gina Baffa, MD. Larger text size Large text size Regular text size. What Is Patent Ductus Arteriosus?

What Happens in Patent Ductus Arteriosus? What Causes Patent Ductus Arteriosus? Babies with a large PDA might have symptoms such as: a bounding strong and forceful pulse fast breathing not feeding well shortness of breath sweating while feeding tiring very easily poor growth How Is Patent Ductus Arteriosus Diagnosed?

Follow-up tests might include: a chest X-ray an EKG , a test that measures the heart's electrical activity and can show if the heart is enlarged an echocardiogram, a test that uses sound waves to diagnose heart problems. Your baby may need tests, such as:. Chest X-ray. A chest X-ray may show an enlarged heart and lung changes in a baby with PDA.

Electrocardiogram ECG. An ECG checks the electrical activity of the heart. It shows abnormal rhythms arrhythmias and heart muscle stress. Echocardiogram echo. An echo uses sound waves to make a moving picture of the heart and heart valves. An echo shows the blood flow pattern through the PDA. It also shows how large the opening is, and how much blood is passing through it.

An echo is the most common way that a PDA is diagnosed. Cardiac catheterization. Typically a catheterization is done to possibly treat a PDA, not diagnose it. It will also depend on how severe the condition is. A small PDA may close on its own as your child grows. A PDA that causes symptoms will need to be treated with medicine, cardiac catheterization, or surgery.

The cardiologist will check from time to time to see if the PDA is closing on its own. If a PDA does not close, it will be fixed to prevent lung problems. Treatment may include the following.

In premature infants, the medicine indomethacin may help close the PDA. It is given by IV intravenously. Indomethacin stimulates the muscles inside the PDA to tighten. This closes the connection. Your child's cardiologist can answer any questions you may have about this treatment.

Some babies may need medicine to help the heart and lungs work better. Sometimes a baby may need medicine such as diuretics water pills. Diuretics help the kidneys remove extra fluid from the body. This may be needed when the heart is not working well. Or it may be needed if the blood vessels in the lungs have to make room for more blood flow, as with a PDA.

Treatment options for a patent ductus arteriosus include monitoring, medications, and closure by cardiac catheterization or surgery. Patent ductus arteriosus symptoms vary with the size of the defect and whether the baby is full term or premature. A small PDA might cause no signs or symptoms and go undetected for some time — even until adulthood.

A large PDA can cause signs of heart failure soon after birth. Your baby's doctor might first suspect a heart defect during a regular checkup after hearing a heart murmur while listening to your baby's heart through a stethoscope.

A large PDA found during infancy or childhood might cause:. Congenital heart defects arise from problems early in the heart's development — but there's often no clear cause. Genetic factors might play a role. Before birth, an opening that connects two major blood vessels leading from the heart — the aorta and pulmonary artery — is necessary for a baby's blood circulation.

The connection diverts blood from a baby's lungs while they develop, and the baby receives oxygen from the mother's circulation. After birth, the ductus arteriosus normally closes within two or three days. In premature infants, the opening often takes longer to close. If the connection remains open, it's referred to as a patent ductus arteriosus. The abnormal 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 pulmonary hypertension and the baby's heart might enlarge and weaken.

A small patent ductus arteriosus might not cause complications. Larger, untreated defects could cause:. Most women who have a small patent ductus arteriosus can tolerate pregnancy without problems. However, having a larger defect or complications — such as heart failure, arrhythmias or pulmonary hypertension — can increase the risk of complications during pregnancy.