Patent Ductus Arteriosus

Patent Ductus Arteriosus General Information

Patent Ductus Arteriosus is considered an unusual opening between two major blood vessels that come from the patient’s heart. The good part about the condition is that it can be detected at birth, when it usually closes on its own, but there are cases in which the doctor can surgically interfere. In the first stages, the medical condition has no signs and symptoms at all, but doctors can discover it by the simple performing of a set of routine exams. As the disease progresses, it can cause trouble in gaining weight; the patient will also develop several signs and symptoms. When the disease affects an older patient who can not be as active as he should normally be, he can tire more easily and he presents an increased risk of developing lung infections.

There are two major treatment options that can be applied to cure the condition and can include medications and surgery. Patent Ductus Arteriosus is common in premature babies or babies who present certain types of congenital heart diseases. In most cases, the disease is caused by the mother lifestyle and medical status during pregnancy and then, the child has an increased risk of developing Patent Ductus Arteriosus, especially if his mother had experienced rubella infection which is the main cause of fetal heart defects. The rubella virus crosses the placenta and affects the fetus’ circulatory system damaging the blood vessels and organs, including heart; diabetes, particularly uncontrolled diabetes affects the fetus’s blood sugar leading to certain damages. Other causes include drug or alcohol over-use or exposure to certain substances. 

Patent Ductus Arteriosus Symptoms

Patent Ductus Arteriosus usually appears in premature babies, but is can also appear in rarer cases in which the child is born at full term. Generally, during the child’s development inside the womb, a vascular connection called ductus asteriosus that develops between two major blood vessels that come from the baby’s heart, aorta and pulmonary arteries, and plays and important role in fetal circulation does not close. In normal cases, this connection closes in the first two or three days after the birth of the child, as he starts adapting to the life outside the womb. That is why, in premature babies, the duct tends not to close causing death due to poor blood circulation. If it is not treated in an early stage, the blood pressure inside the lungs and heart can increase and cause the heart to weaken, leading eventually to the death of the baby.

Doctors do not exclude the idea that the disease can be caused by certain genetic and environmental factors. The symptoms caused by Patent Ductus Arteriosus can differ depending on the size of the effect and the gestational age of the child at birth. In the first stages of the disease, it can cause little to no signs and symptoms, and can progress undetected for a period of time. As Patent Ductus Arteriosus progresses, it can cause heart failure. In the advanced stages, the patient can experience certain signs that include poor eating, poor growth, sweating with crying, persistent fast breathing or breathlessness, easy tiring, rapid heart rate and frequent lung infections.

Patent Ductus Arteriosus Treatment

In most cases, when a patient suffers from Patent Ductus Arteriosus, it has an increased heart rate, and for diagnosing it, doctors can request certain tests for confirming, which can include echocardiogram, which uses sound waves to produce video image of the patient’s heart, and shows the heart chambers which helps the doctor to evaluate how well the heart is pumping blood. This procedure is also used to evaluate heart valves and searches for other minor defects; chest X-ray, which uses X-rays to create an image that helps the doctor to see the stage of the disease and the amount of blood the heart is pumping into the lungs. This kind of procedure is the best way to determine if the baby suffers from certain heart defects; electrocardiogram or EKG, which is a procedure that records the electrical activity of the patient’s heart and helps to diagnose heart defects or heart rhythms problems; and cardiac catheterization, which is a procedure that consists in using a catheter, a small, thin, flexible tube, which is inserted into the patient’s blood vessel at the groin or arm and guided through the heart. By applying this kind of procedure, doctors can perform other tests to evaluate congenital heart dysfunctions that can be found during echocardiography.

In treating Patent Ductus Arteriosus, this procedure can be used along with the available treatment to improve heart function. There are cases in which Patent Ductus Arteriosus is not discovered in the first stages, but only after it progresses and the patient grows. Generally, in a premature baby, the opening closes on its own in several weeks after birth. In a full term baby, the connection generally closes in the first two or three days of life. There are two major treatment options used to treat this kind of disease and can include medications and surgical procedures. In the medication treatment, doctors commonly prescribe nonsteroidal anti inflammatory drugs such as Ibuprofen and Indomethacin, which act by closing the opening, especially in premature infants. These medicines also act by blocking the hormone chemicals in the patient’s body that keep Patent Ductus Arteriosus open.

In more severe cases, to repair the damages caused by the disease, doctors apply the surgical procedures that consist in patching and sewing shut the opening. The procedure is usually done through an incision in the left side of the chest or by catheterization. The catheter is a small, thin tube that goes inserted into the patient’s blood vessel in the groin and threaded up to his heart. Using this procedure, doctors are able to insert a plug or coil that can be deployed to close the opening. During the surgery, this ductus is closed using a metal clip. To prevent the disease from developing, doctors prescribe antibiotics, which are not recommended for all patients who suffer from this kind of disease. These medicines can also be taken by persons who have other heart conditions (apart from Patent Ductus Arteriosus) or artificial valves or who have a large defect that is causing a low blood oxygen level.