Symptoms of Patent Ductus Arteriosus (PDA)
Most Patent Ductus close spontaneously however if they remain open large amount of blood flows to the lungs and causes pulmonary hypertension.
- Most of the premature infants born with Patent ductus arteriosus have spontaneous closure. It is rare in full term babies.
- Respiratory tract infections are common.
- Large amount of blood flow to the pulmonary artery can damage the artery wall.
- Pulmonary hypertension can be a complication that can result in the reversal of the blood flow. Shunting happens from the pulmonary artery to the aorta decreasing the oxygen content in the blood supplying the body. This is called Eisenmenger’s syndrome.
- Large PDAs or untreated PDAs can cause Congestive Heart Failure. Infants present with poor weight gain, failure to thrive or breathing difficulties. Some children may have cyanosis (bluish discoloration of skin, nails, tongue, etc).
- Subacute Bacterial Endocarditis [SBE] develops in patients with small patent ductus arteriosus. It can be prevented and treated with antibiotics. In early days, when antibiotics were not so widely used, SBE used to cause death in about half the patients with PDA.
- Congestive Heart Failure [CHF] is another major complication of a large or untreated PDA. A moderate sized shunt causing persistent increase of volume overload can even cause death in adults. In children, about 30% of death occurs due to CHF.
- Symptoms of heart failure occur much sooner and severe in premature babies than in full term babies.
- Some of the symptoms of heart failure are
- Tachypnea - Rapid breathing.
- Dyspnea – Breathing Difficulties
- Tachycardia – Rapid heart beat (more than 100 beats per minute).
- Poor feeding
- Failure to thrive
- Diaphoresis – Profuse Sweating
- Clubbing – Fingers and toes become round and thick. When the PDA is repaired, clubbing disappears.
- Pounding Heart Beats in the extremities can at times be felt or seen through the skin.
References:Electronic Journal Article
- Indomethacin for asymptomatic patent ductus arteriosus in preterm infants. Cooke L, Steer P, Woodgate P - (http://www.cochrane.org/reviews/en/ab003745.html)
- Prophylactic intravenous Indomethacin for preventing mortality and morbidity in preterm infants. Fowlie PW, Davis PG - (http://www.cochrane.org/reviews/en/ab000174.html)
- Prolonged versus short course of Indomethacin for the treatment of patent ductus arteriosus in preterm infants. Herrera C, Holberton J, Davis P - (http://www.cochrane.org/reviews/en/ab003480.html)
- Ibuprofen for the prevention of patent ductus arteriosus in preterm and/or low birth weight infants. Shah SS, Ohlsson A - (http://www.cochrane.org/reviews/en/ab004213.html)
- Ibuprofen for the treatment of patent ductus arteriosus in preterm and/or low birth weight infants. Ohlsson A, Walia R, Shah S - (http://www.cochrane.org/reviews/en/ab003481.html)
- Oral Ibuprofen for Closure of Hemodynamically Significant PDA in Premature Neonates. Pramila Hariprasad, V. Sundarrajan, G. Srimathy, B. Suthagar, Ramadevi, B. Shyla. Indian Pediatrics 2002; 39: 99-100 - (http://www.indianpediatrics.net/jan2002/jan-99-100.htm)
- Khalil A et al. Incidence of congenital heart disease [PMID: 7875882] - (http://www.ncbi.nlm.nih.gov/sites/entrez? cmd=retrieve&db=PubMed&list_uids=7875882&dopt=medline)
Other Web References
- Patent Ductus Arteriosus (PDA) - (http://www.emedicine.com/emerg/topic358.htm)
- Congenital Heart Defects - (http://www.nhlbi.nih.gov/health/dci/Diseases/pda/pda_what.html)
- PATENT DUCTUS ARTERIOSUS (PDA) - (http://www.heartpoint.com/congpda.html)
- Patent ductus arteriosus - (http://www.nlm.nih.gov/medlineplus/ency/article/001560.htm)