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Patent ductus arteriosus (PDA) is a condition in which a blood vessel called the ductus arteriosus fails to close normally in an infant soon after birth. (The word "patent" means open.)
The condition leads to abnormal blood flow between the aorta and pulmonary artery, two major blood vessels that carry blood from the heart.
Alternative NamesPDA
Causes, incidence, and risk factorsBefore birth, the ductus arteriosus allows blood to bypass the baby's lungs by connecting the pulmonary arteries (which supply blood to the lungs) with the aorta (which supplies blood to the body). Soon after the infant is born and the lungs fill with air, this blood vessel is no longer needed. It will usually close within a couple of days. If the ductus arteriosus does not close, there will be abnormal blood circulation between the heart and lungs.
PDA affects girls more often than boys. The condition is more common in prematureinfants and those with neonatal respiratory distress syndrome. Infants with genetic disorders, such as Down syndrome, and whose mothers had rubella during pregnancy are at higher risk for PDA.
PDA is common in babies with congenital heart problems, such as hypoplastic left heart syndrome, transposition of the great vessels, and pulmonary stenosis.
SymptomsA small PDA may not cause any symptoms. However, some infants may not tolerate a PDA, especially if it is large, and may have symptoms such as:
- Bounding pulse
- Fast breathing
- Poor feeding habits
- Shortness of breath
- Sweating while feeding
- Tiring very easily
- Poor growth
Babies with PDA often have a characteristic heart murmur that can be heard with a stethoscope. However, in premature infants, a heart murmur may not be heard. Doctor's may suspect the condition if the infant has breathing or feeding problems soon after birth.
Changes may be seen on chest x-rays. The diagnosis is confirmed with an echocardiogram.
Sometimes, a small PDA may not be diagnosed until later in childhood.
TreatmentThe goal of treatment, if the rest of circulation is normal or close to normal, is to close the PDA. In the presence of certain other heart problems, such as hypoplastic left heart syndrome, the PDA may actually be lifesaving and medicine may be used to prevent it from closing.
Sometimes, a PDA may close on its own. Premature babies have a high rate of closure within the first 2 years of life. In full-term infants, a PDA rarely closes on its own after the first few weeks.
When treatment is appropriate, medications such as indomethacin or a special form of ibuprofen are generally the first choice.
If these measures do not work or can't be used, a medical procedure may be needed.
A transcatheter device closure is a minimally invasive procedure that uses a thin, hollow tube. The doctor passes a small metal coil or other blocking device through the catheter to the site of the PDA. This blocks blood flow through the vessel. Such endovascular coils have been used successfully as an alternative to surgery.
Surgery may be needed if the catheter procedure does not work or cannot be used. Surgery involves making a small cut between the ribs to repair the PDA.
Expectations (prognosis)If a small PDA remains open, heart symptoms may or may not eventually develop. Persons with a moderate or large PDA could eventually develop heart problems unless the PDA is closed.
Closure with medications can work very well in some situations, with few side effects. Early treatment with medications is more likely to be successful.
Surgery carries its own significant risks. It may eliminate some of the problems of a PDA, but it can also introduce a new set of problems. The potential benefits and risks should be weighed carefully before choosing surgery.
ComplicationsIf the patent ductus is not closed, the infant has a risk of developing heart failure, pulmonary artery hypertension, or infective endocarditis -- an infection of the inner lining of the heart.
Calling your health care providerThis condition is usually diagnosed by a doctor examining your infant. Breathing and feeding problems in an infant can occasionally be due to an undiagnosed PDA.
PreventionPreventing preterm deliveries, where possible, is the most effective way to prevent PDA.
ReferencesZipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 8th ed. St. Louis, Mo; WB Saunders; 2007.
What else can I help you with?
What structure is used to connect the aorta and the pulmonary artery in fetal circulation?
Ductus arteriosus
What does the medical abbreviation PDA mean?
Patent Ductus Arteriosus
What murmur radiates to the back?
Patent ductus arteriosus, or PDA, is a type of heart murmur that radiates to the back. It occurs when an infant's ductus arteriosus does not close after birth.
Patent ductus arteriosus or posterior descending artery?
Also known as PDA. A condition in premature infants which causes abnormal fetal circulation
Why is there bounding peripheral pulse in patent ductus arteriosus?
The output runoff through the PDA from the left ventricle's output to the pulmonary circulation causes a lower diastolic pressure resulting in a lower than normal pressure in diastole. This gives the feeling of a bounding pulse when the heart beats due to the increased difference between the systolic and diastolic pressure and is interpreted as a bounding pulse in the peripheral vessels.
What is the fate of the ductus arteriosus?
The ductus arteriousus connects the pulmonary artery with the descending thoracic aorta, allowing the blood to enter into the fetal circulation without going through the lungs. This structure closes at birth and becomes the "ligamentum arteriosus."
Congenital connection between the pulmonary artery and the aorta?
A congenital connection between the pulmonary artery and the aorta is known as a patent ductus arteriosus (PDA). This condition can lead to abnormal blood flow between the two major blood vessels, causing symptoms such as shortness of breath, heart murmurs, and poor feeding. Treatment typically involves medication or surgery to close the connection and restore normal blood flow.
What is arteriosus?
Patent Ductus ArteriosusPatent ductus arteriosus (PDA) is a heart problem that occurs soon after birth in some babies. In PDA, abnormal blood flow occurs between two of the major arteries connected to the heart.Before birth, the two major arteries-the aorta and the pulmonary (PULL-mun-ary) artery-are connected by a blood vessel called the ductus arteriosus. This vessel is an essential part of fetal blood circulation.Within minutes or up to a few days after birth, the vessel is supposed to close as part of the normal changes occurring in the baby's circulation.In some babies, however, the ductus arteriosus remains open (patent). This opening allows oxygen-rich blood from the aorta to mix with oxygen-poor blood from the pulmonary artery. This can put strain on the heart and increase blood pressure in the lung arteries.
What is the medication therapy for patent ductus arteriosis?
Of all the congenital heart diseases, patent ductus arteriosis (PDA) is the only disease that can be treated.The PDA treatment algorithm includes the following:Fluid restrictionDiureticsNon-steroidal anti-inflammatory drugs (NSAIDs) [See elaboration below.] Indomethacin, ORIbuprofenSurgical ligation When NSAIDs fail to treat the PDA.NSAIDs Comparison:Indomethacin Doses: Initial dose: 0.2 mg/Kg Intravenously (IV)Subsequent doses varies Post natal age - increase dose with increased ageInfant renal function - increase dosing interval for poor renal function.Ibuprofen Doses: Initial dose: 10 mg/Kg IVSubsequent dose: 5 mg/Kg IV daily for 2 days.Note: Calculate dosing for both drugs using the infant's birth weight.COX-1 inhibition (COX-1 is responsible for inflammation, so higher inhibition of COX-1 is preferred.) Indomethacin > IbuprofenStability Indomethacin (12 days) > Ibuprofen (30 minutes)Degree of protein binding (May cause accumulation of bilirubin in the brain, otherwise known as "kernicterus," which is associated with cerebral palsy.) Occurs in both NSAIDsMore incidents reported on ibuprofen.Efficacy in treating PDA Indomethacin = IbuprofenIndomethacin is generally the preferred medication for PDA treatment.Adverse Effects from Both NSAIDs Oliguria, renal failureGastrointestinal bleedingBowel perforationNecrotizing enterocolitisIntraventricular hemorrhageThrombocytopeniaContraindication to use NSAIDs (Do not use NSAIDs, if the following occurs.) Necrotizing enterocolitisIntraventricular hemorrhageActive bleedingThrombocytopeniaImpaired renal functions
Problem with heart what does PDA mean?
Patent Ductus Arteriosus (PDA) is a congenital heart defect wherein a child's ductus arteriosus fails to close after birth. Symptoms are uncommon but in the first year of life include increased work of breathing and poor weight gain. In older children or adults the PDA may lead to congestive heart failure if left uncorrected. PDA, is a heart condition that is normal but reverses soon after birth. In a persistent PDA, there is an irregular transmission of blood between two of the most important arteries in close proximity to the heart. Although the ductus arteriosus normally seals off within a few days, in PDA, the newborn's ductus arteriosus does not close, but remains patent. PDA is common in infants with persistent respiratory problems such as hypoxia, and has a high occurrence in premature children. In hypoxic newborns, too little oxygen reaches the lungs to produce sufficient levels of bradykinin and subsequent closing of the DA. Premature children are more likely to be hypoxic and thus have PDA because of their underdeveloped heart and lungs. A Patent Ductus Arteriosus allows that portion of the oxygenated blood from the left heart to flow back to the lungs (following the pressure gradient from the higher pressure aorta to the pulmonary arteries). If this shunt amount is substantial, the infant becomes short of breath because there is not only the normal amount of unoxygenated blood that has returned from the body to go to the lungs but in addition there is the amount shunted through the PDA. The infant's work of breathing is increased, using up more calories and often interfering with feeding in infancy. This condition as a constellation of findings is called congestive heart failure. In some cases, such as in transposition of the great vessels (the pulmonary artery and the aorta), a PDA may need to remain open. In this cardiovascular condition, the PDA is the only way that oxygenated blood can mix with deoxygenated blood. In these cases, prostaglandins are used to keep the patent ductus arteriosus open. While some cases of PDA are asymptomatic, common symptoms include: * tachycardia or other arrhythmia * respiratory problems * shortness of breath * continuous machine-like murmur * enlarged heart PDA is usually diagnosed using non-invasive techniques. Echocardiography, in which sound waves are used to capture the motion of the heart, and associated Doppler studies are the primary methods of detecting PDA. Electrocardiography (ECG), in which electrodes are used to record the electrical activity of the heart, is not particularly helpful as there are no specific rhythms or ECG patterns which can be used to detect PDA. A chest X-ray may be taken, which reveals the overall size of infant's heart (as a reflection of the combined mass of the cardiac chambers) and the appearance of the blood flow to the lungs. A small PDA most often shows a normal sized heart and normal blood flow to the lungs. A large PDA generally shows an enlarged cardiac silhouette and increased blood flow to the lungs. Infants without adverse symptoms may simply be monitored as outpatients, while symptomatic PDA can be treated with both surgical and non-surgical methods.[1] Surgically, the DA may be closed by ligation, wherein the DA is manually tied shut, or with intravascular coils or plugs that leads to formation of a thrombus in the DA. Fluid restriction and prostaglandin inhibitors such as indomethacin have also been used in successful non-surgical closure of the DA. This is an especially viable alternative for premature infants. In certain cases it may be beneficial to the newborn to prevent closure of the ductus arteriosus. For example, in transposition of the great vessels a PDA may prolong the child's life until surgical correction is possible. The ductus arteriosus can be induced to remain open by administering prostaglandin analogs such as alprostadil (a prostaglandin E1 analog). Recent days PDA can be closed by percutaneous interventional method, through femoral vein or femoral artery, a coil can be placed with the help of myocardial forceps to make an embolus, which closes the PDA without any surgery. Also A (Personal Digital Assistant) refers to a hand-held device that incorporates several handy features.PDAs often include an address book, calendar, contacts list, and a memo feature.Most modern PDAs support internet access and include software you would normally find on an office computer, such as word processing and spreadsheet software.Below are some typical features you will find in modern PDAs * Integrated WLAN adaptors * Integrated microphone and speaker * 240x320 screen resolution * USB ports * Microsoft Outlook * Microsoft Internet Explorer The operating systems are specially designed for PDAs, the performance depends on the processor speed and memory, a typical PDA would boast a 300MHz processor and 64MB of ram.
How long does it take hole in heart to close after birth?
After birth, a congenital heart defect known as a patent ductus arteriosus (PDA) or patent foramen ovale (PFO) may close naturally within the first few days to weeks. In many cases, these openings can close by themselves within the first year of life. However, some may remain open and require medical intervention if they cause significant problems. Regular pediatric check-ups can help monitor the condition and determine if treatment is necessary.
What is a PDA in an aircraft?
what is a pda in an aircraft
