Patent Ductus Arteriosus (PDA)

Overview

What is patent ductus arteriosus (PDA)?

Patent ductus arteriosus (PDA) is a heart condition in babies. It happens when a blood vessel called the ductus arteriosus doesn’t close as it should after birth.

What does the ductus arteriosus do?

During fetal development (before a baby is born), very little blood flows to a baby’s lungs. Instead, most of the blood bypasses the baby’s lungs. One way for this to happen is that blood flows from the main heart artery (aorta) to the primary lung artery (pulmonary arteries) through a special fetal blood vessel (ductus arteriosus). This blood vessel usually closes during the baby’s first few days of life when the blood flows to the baby’s lungs.

What happens in babies with patent ductus arteriosus?

When a baby has a PDA, the ductus arteriosus doesn’t close properly. A small opening is left. The opening allows extra blood from the aorta to enter the baby’s lung arteries. Depending on the size of this blood vessel, your baby’s heart and lungs may have to work harder to pump blood.

Who does PDA affect?

Babies born prematurely are more likely to have a PDA. The condition is also more common in girls than boys.

How common is PDA?

Patent ductus arteriosus is the most common heart condition in newborns. Healthcare providers diagnose the condition more often in premature babies. The risk increases the earlier the baby is born. PDA happens in about:

  • 10% of babies born between 30 and 37 weeks of pregnancy.
  • 80% of babies born between 25 and 28 weeks of pregnancy.
  • 90% of babies born earlier than 24 weeks of pregnancy.

How does PDA affect my baby?

A moderate or large PDA can cause babies to breathe faster and harder than normal, as their bodies try to keep up with the extra blood in their lung arteries. If left untreated for a prolonged period, a PDA can lead to the development of pulmonary hypertension (high blood pressure in the lungs) and blood vessel damage.

Symptoms and Causes

What causes patent ductus arteriosus?

Researchers don’t know for sure why this condition happens. Patent ductus arteriosus causes may include genetic disorders or a family history of the condition. Other PDA causes may include:

  • German measles during pregnancy: Babies born to mothers who had rubella (German measles) during pregnancy may have a higher risk of a PDA.
  • Neonatal respiratory distress syndrome: Babies whose lungs didn’t get enough lubricating substance (surfactant) before birth may develop neonatal respiratory distress syndrome, a breathing problem. These babies may also develop a PDA.

What are patent ductus arteriosus symptoms?

PDA symptoms vary according to patent ductus arteriosus types. Small PDAs may not cause any symptoms other than a heart murmur.

Larger PDAs may cause:

Diagnosis and Tests

How do healthcare providers diagnose PDA?

If you notice symptoms of a PDA in your baby, tell your healthcare provider. Your provider may hear a patent ductus arteriosus heart murmur during a well-baby care visit or physical examination.

What tests do providers use to diagnose patent ductus arteriosus?

If your healthcare provider suspects PDA, they may recommend referral to a specialist, a pediatric cardiologist. The pediatric cardiologist may order certain tests, including:

Do healthcare providers diagnose PDA in adults?

Healthcare providers sometimes diagnose PDA in adults. If you had a small PDA as a baby, you may not have gotten treatment. Symptoms can include:

Management and Treatment

How do healthcare providers treat PDA?

Your healthcare provider will consider your baby’s age, size and health when determining a treatment plan. They might recommend observation (watchful waiting) to see if the PDA will close on its own. A watchful waiting approach involves regular checkups and tests so the provider can see if the PDA is closing. Occasionally, treatment may not be necessary.

What medications do providers use to treat PDA?

Healthcare providers may treat patent ductus arteriosus with medication, including nonsteroidal anti-inflammatory drugs (NSAIDs). Medications may encourage patent ductus arteriosus closure. This is commonly used in premature babies, but not in older children or adults.

What are other types of patent ductus arteriosus treatment?

Healthcare providers may treat PDA with surgical procedures, including:

  • Cardiac catheterization: During cardiac catheterization, experts insert a thin, flexible tube (catheter) into the groin and thread it up through a blood vessel to the heart. They insert a plug or coil into the heart through the catheter to close the PDA and stop patent ductus arteriosus blood flow. Providers typically don’t perform cardiac catheterization on premature babies, though older babies and children can have this procedure.
  • Patent ductus arteriosus surgery: Surgeons make an incision in the side of the chest. They close the PDA with stitches (sutures) or a metal clip.

How soon after treatment will blood flow return to normal?

After catheterization or surgery, blood flow returns to normal immediately if there are no other heart defects.

Are there other complications from PDA?

Closing the PDA gets blood flow back to normal. After closure via a cardiac catheterization, your child will take antibiotics for six months to prevent heart infection (endocarditis). Your healthcare provider will discuss the necessary follow-up care with you.

Adults who have PDA closure procedures will also take antibiotics for six months and should see a cardiologist for follow-up care.

Prevention

How can I prevent my baby from developing patent ductus arteriosus?

There isn’t anything you can do to prevent PDA.

Are there conditions that put my baby at higher risk for PDA?

If you have rubella during pregnancy, your baby may be at higher risk of developing PDA. Tell your healthcare provider right away if you’re exposed to rubella during pregnancy.

Outlook / Prognosis

What can I expect if my baby has PDA?

With treatment, most babies born with PDA live healthy and active lives.

Is patent ductus arteriosus curable?

If PDA doesn’t close on its own, healthcare providers can correct it, if needed. Babies and children with moderate and large sized PDA’s that are not treated in the correct timeframe may be at higher risk for developing heart complications as adults. Talk with your healthcare provider about whether your baby needs follow-up care.

Living With

How do I take care of my baby with patent ductus arteriosus?

Follow all instructions from your healthcare provider. Keep all follow-up appointments and let your provider know right away if your baby develops new symptoms.

When should I call my healthcare provider?

Call your provider if your baby develops new symptoms. If your baby has trouble breathing, seek emergency care right away.

A note from Cleveland Clinic

Patent ductus arteriosus (PDA) is a congenital heart condition. With treatment, your child can live an active and healthy life. Talk with your healthcare provider about the best treatment options.

Last reviewed by a Cleveland Clinic medical professional on 04/25/2022.

References

  • American Heart Association. Patent Ductus Arteriosus (PDA). (https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/patent-ductus-arteriosus-pda) Accessed 4/25/2022.
  • Ohlsson A, Walia R, Shah SS. Ibuprofen for the treatment of patent ductus arteriosus in preterm or low birth weight (or both) infants. (https://pubmed.ncbi.nlm.nih.gov/32045960/) Cochrane Database Syst Rev. 2020 Feb 11;2(2):CD003481. Accessed 4/25/2022.
  • Parkerson S, Philip R, Talati A, Sathanandam S. Management of Patent Ductus Arteriosus in Premature Infants in 2020. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7904697/) Front Pediatr. 2021;8:590578. Published 2021 Feb 11. Accessed 4/25/2022.
  • Wiyono SA, Witsenburg M, de Jaegere PP, Roos-Hesselink JW. Patent ductus arteriosus in adults: Case report and review illustrating the spectrum of the disease. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2516289/) Neth Heart J. 2008;16(7-8):255-259. Accessed 4/25/2022.

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