Patent Ductus Arteriosus

Before birth the body receives oxygen from the placenta instead of the lungs. During this time most blood goes around the lungs by passing through a blood vessel called the ductus arteriosus. The ductus arteriosus connects two arteries in the heart: the artery that leads to the lungs (pulmonary artery) and the artery that leads to the body (aorta).

The ductus arteriosus usually closes up after birth when blood begins going to the lungs instead of around them and the connection is no longer needed. Most of the time it closes fully within a few days after birth, but it may take longer to close in children born prematurely or who are very sick when they are born. If it does not close, it is called an open (patent) ductus arteriosus.

ExitCare ImagePatent ductus arteriosus is a heart defect. A patent ductus arteriosus allows some blood to flow from the aorta into the pulmonary artery. This causes there to be more blood going to the lungs than is normal. The extra blood can cause the left side of the heart to enlarge. It can also increase the blood pressure in the lungs and strain the heart. If left untreated, patent ductus arteriosus can lead to heart failure, be a source of infection in the heart, or cause other problems. Patent ductus arteriosus does not always cause problems, especially if the opening is very small.

CAUSES

The cause of patent ductus arteriosus is unknown.

RISK FACTORS

  • Being born prematurely.

  • Being born at a high altitude.

  • Having certain genetic conditions, such as Down syndrome.

  • Being female.

SYMPTOMS

Most children with patent ductus arteriosus do not have symptoms. If symptoms are present, they may include:

  • Fast or difficult breathing.  

  • Feeding problems.  

  • Poor weight gain.  

  • Low energy (listlessness).  

  • Tiring easily.  

  • Feeling cold, clammy, and sweaty.  

DIAGNOSIS

Patent ductus arteriosus is often found when a health care provider listens to your child's heart and hears an extra or unusual sound (heart murmur). To diagnose the condition, the health care provider may order some tests, including:

  • A chest X-ray.  

  • Echocardiography. This is a test that produces images of the heart by using sound waves.  

  • Electrocardiography. This is a test that records the electrical forces of the heart.

TREATMENT

The ductus arteriosus may close on its own without treatment. For children born prematurely, a type of medicine called a nonsteroidal anti-inflammatory drug (NSAID) may be given to help the ductus arteriosus close. If the ductus arteriosus does not close on its own or with medicines, or if it is causing serious problems, a procedure may need to be done to close it. There are two ways to close the ductus arteriosus. One is with surgery. The other is by using a catheter. Your child's health care provider will decide which procedure is best for your child based on factors such as age, weight, symptoms, and the shape of the patent ductus arteriosus.

HOME CARE INSTRUCTIONS

  • Only give over-the-counter or prescription medicines as directed by your child's health care provider. Do not give aspirin to children unless instructed to do so by your child's pediatrician or cardiologist.  

  • Give your child antibiotic medicine as directed. Make sure your child finishes it even if he or she starts to feel better.  

  • Make sure to brush and floss your child's teeth regularly. This helps to prevent infection.  

  • Schedule regular dental checkups for your child.

SEEK MEDICAL CARE IF:

  • Your child has fast or difficult breathing.  

  • Your child coughs more than usual.  

  • Your child's symptoms get worse or new symptoms develop.  

  • Your child is not acting normally.  

  • Your child is not gaining weight or is gaining weight very slowly.  

  • Your child is listless.  

  • Your child gets tired very easily when eating or crying.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child has feeding problems.  

  • Your child is cold, clammy, and sweaty.  

  • Your child who is younger than 3 months has a fever.  

  • Your child who is older than 3 months has a fever and persistent symptoms.  

  • Your child who is older than 3 months has a fever and symptoms suddenly get worse.