CHECK-UP:Patent ductus arteriosus is a heart problem that occurs in some babies, writes Marion Kerr
MY GRANDCHILD was born seven weeks earlier than expected. Although she is now doing okay, she has been diagnosed with a heart problem called patent ductus arteriosus. What is this and what could have caused it?
Patent ductus arteriosus (PDA) is a heart problem that occurs soon after birth in some babies. Before birth, a blood vessel called the ductus arteriosus connects two major arteries: the aorta and the pulmonary artery.
As the foetus does not breathe while in the womb, this blood vessel allows the blood to bypass the lungs.
However, once the baby is born and needs to breathe, blood must be directed through the lungs to be oxygenated. In the majority of babies, the ductus arteriosus naturally closes within days (up to two weeks) following birth.
When the connection remains open (patent) it can put a strain on the heart and increase the blood pressure in the lung arteries.
The cause of PDA is not known but genetics is thought to play a role. Although it is more common in premature infants, it can also occur in full-term babies. The condition is twice as common in girls as boys.
What are the usual signs of this condition?
Babies with a large PDA typically develop symptoms such as fast breathing, poor feeding, failure to gain weight, become easily tired and sweating.
For babies with a small PDA, a heart murmur may be the only indication that something is amiss, but this sign is not always present.
Echocardiogram - a painless ultrasound of the heart - is the most common test used to confirm the diagnosis of PDA while an electrocardiogram (ECG) may also be performed to record the electrical activity of the heart.
Is surgery always needed?
No. Small PDAs often close naturally without intervention and the type and timing of other treatment options will very much depend on the degree of symptoms the baby is experiencing.
In a full-term baby, treatment is needed if the PDA is large, causing health problems or does not close on its own by the time the child is about two years old. In pre-term infants, treatment is needed if the PDA is causing increased respiratory distress or heart problems.
Treatment options include the use of drugs to help close the PDA and to prevent infection developing; using a catheter to place a small blocking device in the ductus arteriosus to prevent the blood flow through the vessel; and surgical closure of the ductus arteriosus.