Patent Ductus Arteriosus – Symptoms and Causes
Overview
Patent ductus arteriosus (PDA) is a heart condition where an opening between two main blood vessels from the heart stays open after birth.
In a developing fetus, this opening helps blood circulation, but it normally closes shortly after birth. When it remains open, it’s classified as a congenital heart defect.
The severity of a PDA varies. Small openings may not require treatment and might not cause symptoms. However, larger openings can cause problems by allowing oxygen-poor blood to flow in the wrong direction.
This can lead to heart muscle weakening, heart failure, and other health complications.
Symptoms
Having a patent ductus arteriosus (PDA) may cause different symptoms based on the size of the opening and the person’s age.
Some people with a small PDA might not notice any symptoms at all. For others, symptoms might not appear until they reach adulthood.
A large PDA can cause these problems:
- Poor feeding leading to slow growth
- Sweating during crying or eating
- Breathing difficulties or rapid breathing
- Getting tired easily
- Fast heart rate
When To Call a Doctor
Contact your healthcare provider if you notice your child:
- Gets tired quickly while eating or playing
- Isn’t growing properly
- Has trouble breathing when eating or crying
- Breathes rapidly or seems short of breath often
These signs might indicate a heart problem that needs medical attention. Early treatment can help prevent complications.
Causes
Patent ductus arteriosus begins during fetal development. The ductus arteriosus is a normal opening between two major blood vessels leaving the heartโthe aorta and pulmonary artery.
This opening is essential before birth because it allows blood to bypass the lungs, which aren’t yet functioning. Instead, the baby receives oxygen through the mother’s blood.
After birth, the ductus arteriosus should close naturally within 2-3 days. However, in some babies, this opening remains patent (open). When this happens, it creates an abnormal blood flow pattern.
The specific reasons why the ductus remains open in some infants aren’t fully understood. Heart defects like patent ductus arteriosus typically develop during the first six weeks of pregnancy when the heart and major blood vessels are forming.
When the ductus stays open, it causes several problems:
- Too much blood flows to the lungs
- The heart works harder than normal
- Blood pressure in the lungs may increase
- The heart may enlarge and weaken over time
Risk Factors
Several factors can increase the chance of developing patent ductus arteriosus:
- Premature birth is the most common risk factor, as early delivery often prevents normal closure of the ductus arteriosus.
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Genetic factors play a role, including:
- Family history of congenital heart conditions
- Down syndrome (trisomy 21)
- Pregnancy exposures such as rubella (German measles) infection during pregnancy can affect heart development.
- High altitude birth increases risk, particularly for babies born above 8,200 feet (2,499 meters).
- Female babies have about twice the risk compared to males.
Pregnant women can get tested for rubella immunity before pregnancy. A vaccine is available for those who aren’t immune, which can protect future pregnancies.
These risk factors don’t guarantee that patent ductus arteriosus will occur, but they do increase the likelihood compared to babies without these factors.
Health Issues
PDA and Pregnancy
Pregnant women with a small patent ductus arteriosus (PDA) can often have healthy pregnancies. However, larger PDAs or existing complications like heart failure create serious risks during pregnancy.
If you have PDA and want to become pregnant, talk with your doctor first. Some heart medications can harm developing babies. Your healthcare provider might need to change or stop certain medicines before you try to conceive.
Important pregnancy considerations:
- Your doctor can create a special care plan for your pregnancy
- Genetic testing may be recommended if your baby has higher risk of heart problems
- Regular monitoring throughout pregnancy will be necessary
Women with untreated larger PDAs face greater pregnancy risks due to the extra blood flow demands that pregnancy places on the heart.
Small PDAs typically cause few problems during pregnancy, but larger ones can lead to:
- High blood pressure in the lungs
- Heart failure symptoms
- Increased risk of heart infection
Always seek medical advice specific to your situation from a qualified healthcare professional before planning pregnancy with any heart condition.
Prevention
There is no known way to prevent patent ductus arteriosus. However, taking steps for a healthy pregnancy can support your baby’s overall development.
Start with early prenatal care, ideally before conception. Meet with healthcare providers to create a care plan. Also, discuss all medications you take, including over-the-counter ones.
Begin taking 400 micrograms of folic acid daily before and during pregnancy. This nutrient helps reduce the risk of brain, spinal cord, and possibly heart conditions in babies.
Physical activity matters too. Work with your healthcare provider to develop an appropriate exercise routine that’s safe for your pregnancy.
Important lifestyle changes:
- Avoid alcohol completely
- Don’t smoke and stay away from secondhand smoke
- Get recommended vaccines before pregnancy
- Control blood sugar if you have diabetes
These healthy habits can make a difference in your baby’s development. Diabetes management is particularly important, as poor blood sugar control may increase the risk of congenital heart conditions.
Remember to update your vaccinations before becoming pregnant. Certain infections can harm developing babies.
