The human heart has two major blood vessels leading from the heart, which consist of a persistent opening known as the ductus arteriosus. This opening is a normal part of a baby’s circulatory system, which gets closed shortly after birth. If this opening remains open after birth, it is called a patent ductus arteriosus(PDA). In simple words, it is an unclosed hole in the aorta.
A minor patent ductus arteriosus often does not cause many problems and might not need treatment. But the heart can pump poorly oxygenated blood in the wrong direction if the opening is large and left untreated. It can also result in the weakening of the heart muscle, causing heart failure and other complications.
It was reported that only 1 out of 2,000 births had developed patent ductus arteriosus (PDA), accounting for 5% to 10% of all congenital heart disease. It was also suggested that patent ductus arteriosus(PDA) occurs mainly due to a lack of standard closure mechanisms due to immaturity.
It has been noticed that patent ductus arteriosus (PDA) is present in 80% of the infants having weight less than 1,200 g at the time of birth as compared to 40% of infants having weight less than 2,000 g at birth. The patent ductus arteriosus(PDA) is inversely linked with birth weight and the incidence of PDA.
It has been noted that 80% of the preterm infants suffering from Respiratory Distress Syndrome(RDS) also develop patent ductus arteriosus (PDA). Patent ductus arteriosus treatment includes monitoring, medications, and closure by cardiac catheterization or surgery.
Patent Ductus Arteriosus Symptoms
The symptoms of patent ductus arteriosus depend on the size of the defect and whether the baby is full-term or premature. A person suffering from minor patent ductus arteriosus does not show any signs or symptoms and therefore, can remain undetected for some time(in some cases, adulthood).
But a baby with a large patent ductus arteriosus can show signs and symptoms of heart failure soon after the birth.
The doctor will be able to first detect the defect during a regular checkup after hearing a heart murmur after listening to the baby’s heart through a stethoscope. A major patent ductus arteriosus may cause:-
- A poor diet that leads to improper growth
- Sweating while crying or eating
- Persistent to fast breathing or breathlessness
- Rapid heartbeat
Immediately contact the doctor if your child experiences the following symptoms:-
- Tiredness while eating or playing
- Facing problem in gaining weight
- Breathlessness while eating or crying
- Rapid breathing or shortness in breathing
What Are The Causes Of Patent Ductus Arteriosus?
Patent ductus arteriosus is caused early from problems in the heart’s development, but there is no apparent cause of it, genetic factors might play a role in the development of patent ductus arteriosus.
Before the time of birth, two major blood vessels(the aorta and the pulmonary artery) from the heart of the baby are connected vascularly(ductus arteriosus) for the baby’s circulatory system. This ductus arteriosus helps the baby to divert blood from his lungs while they develop, making the baby receive oxygen from the mother’s circulatory system.
After the birth, this ductus arteriosus gets closed within two to three days and in the case of premature infants, this vascular connection often takes longer to close. In case the connection remains open, it is called patent ductus arteriosus.
Severe patent ductus arteriosus will cause too much blood to circulate to the baby’s lungs and heart. If left untreated, it will lead to pulmonary hypertension, high blood pressure in the baby’s lungs.
What Are The Risk Factors Associated With Patent Ductus Arteriosus?
The risk factors that can trigger the symptoms of the patent ductus arteriosus(PDA) are:-
- Premature birth: Patent ductus arteriosus(PDA) usually happens when the baby is born too early than in babies who are born full-term.
- Family history: If your family member is suffering from heart defects, such as down syndrome, it increases the risk of developing a patent ductus arteriosus (PDA).
- Rubella infection at the time of pregnancy: If you are infected with German measles(rubella) at the time of pregnancy, the risk of developing heart disease of your baby increases. In such a case, the rubella virus crosses the placenta and spreads in the circulatory system of the baby that causes damage to the blood vessels and organs, such as the heart.
- Babies born at high altitudes: Babies born at high altitudes, above 10,000 feet(3,048 meters), are at higher risk of developing patent ductus arteriosus(PDA) as compared to babies born at a lower altitude.
- Baby Girl: Patent ductus arteriosus(PDA) is twice as common in girls.
Any Restrictions For A Child Having PDA?
If a child is suffering from minor patent ductus arteriosus or if the connection has been closed by the surgery then the child may not need to take any special precautions regarding physical activity.
As per the type of PDA closure, the pediatric cardiologist might need to examine the child periodically to prevent any uncommon problem. But such surgery has been proven to be successful for a long term outlook.
Complications Related To Patent Ductus Arteriosus(PDA)
A minor patent ductus arteriosus(PDA) will not cause that many severe complications as compared to major patent ductus arteriosus(PDA) if left untreated, such as:-
- Pulmonary hypertension: When a large amount of blood circulates from the heart’s main arteries to a patent ductus arteriosus, blood pressure in the lungs increases, causing pulmonary hypertension. It can cause permanent lung damage.
A major patent ductus arteriosus(PDA) can cause an irreversible type of pulmonary hypertension known as Eisenmenger syndrome.
- Heart failure: A patent ductus arteriosus(PDA) can lead to enlargement and weakening of the heart, which can further lead to heart failure(it is a chronic condition in which the heart is unable to pump blood effectively).
- Heart infection(endocarditis): A patent ductus arteriosus(PDA) is a kind of structural heart problem that creates a high risk of inflammation in the inner lining of the heart (infectious endocarditis) when compared to people who have healthy hearts.
Patent Ductus Arteriosus(PDA) and Pregnancy
Women suffering from a minor patent ductus arteriosus(PDA) may be able to tolerate pregnancy without any problems. But if an expecting woman has major patent ductus arteriosus(PDA) or other complications, such as heart failure, arrhythmias, or pulmonary hypertension, it can increase the risk of complications during pregnancy.
Please note, if you are expecting a baby and have Eisenmenger syndrome, you should avoid pregnancy as it can be life-threatening.
In case you ever had a heart defect and thinking of family planning, do consult your doctor first before taking any step. In some situations, you might need high-risk obstetric care and preconception consultations with the doctor specialized in congenital cardiology and genetics.
These preventive measures are taken because some medicines for heart defects may cause severe complications for a developing baby, and the doctor might feel necessary to stop or adjust the medication before pregnancy.
Prevention Form Patent Ductus Arteriosus(PDA)
There is no way to prevent pregnancy with a patent ductus arteriosus(PDA), but you can take some preventive measures to have a healthy pregnancy, such as:-
- Early preventive care before pregnancy: There are things that you should talk to your doctor before getting pregnant, such as quit smoking, reduce stress, and stop birth control. Do not forget to tell your doctor about the medications you had used or have been using.
- Consume a healthy diet: People suffering from patent ductus arteriosus(PDA) should include vitamin supplements that contain folic acid.
- Exercise regularly: Consult with your doctor and prepare an exercise plan that suits your health.
- Avoid taking risks: The term ‘risk’ indicates alcohol, tobacco, illegal drugs, hot tubs, and saunas.
- Avoid infections: It is necessary to update your vaccinations before becoming pregnant because some types of infections can be harmful to a developing baby.
- Control your diabetes: It is essential to control your diabetes, work with your doctor to maintain your health condition and diabetes level, especially during pregnancy.
If any of your family members is a heart disease patient, to be safe, do consult with a genetic counselor before pregnancy.