Patent Ductus Arteriosus

Overview

Patent ductus arteriosus (PDA) is a congenital heart defect that occurs when an artery called the ductus arteriosus stays open after birth instead of closing. In the womb, this artery routes blood away from the lungs. But when a baby starts breathing air after birth, the artery is no longer needed and typically closes within days. A PDA can cause the lung arteries to receive too much blood, which can tax the heart and lungs.

If you have a PDA, you were likely diagnosed in infancy or childhood, and you may have received medication or surgery to close it, depending on its size and other factors. Whether the PDA remains open or was closed years ago, it’s important to continue to see a cardiologist as an adult to be monitored for complications, such as high blood pressure in the arteries of the lungs, which is also known as pulmonary hypertension.

Symptoms

If you have a small PDA, you likely won’t experience symptoms, although you may have a heart murmur that is detectable with a stethoscope. If you have a large PDA, you may get out of breath easily or have pulmonary hypertension.

Prevention

PDA is a condition that is present at birth and is not preventable.

Risk Factors

Girls are more likely to be born with a PDA than boys. You are more likely to have a PDA if you:

Had neonatal respiratory distress syndrome at birth
Have a genetic disorder, such as Down syndrome
Were born premature

You also have a higher risk of a PDA if your mother had the viral infection rubella while pregnant with you.

Diagnosis

Medical history. Most cases of PDA are diagnosed in babies or children and, if necessary, treated at a young age. It is rare for this condition to be diagnosed in adults. When that is the case, the diagnostic process begins with obtaining a medical history. Your cardiologist will ask about any medical conditions you may have, your medications and any symptoms you may have experienced. The cardiologist will want to know whether you’ve been diagnosed with or treated for any congenital heart defects.
Physical exam. The cardiologist will examine you and listen to your heart with a stethoscope. A heart murmur that is audible with a stethoscope may be a sign of a PDA.
Echocardiogram. An echocardiogram uses ultrasound to help the cardiologist assess your heart’s size and functional capacity, including how blood moves through it.
Electrocardiogram. This test of the heart’s electrical activity can detect abnormalities in the muscle’s rhythm that may be related to a PDA.

Treatment

Whether you need treatment for a PDA as an adult depends on the defect’s size and status.

If the PDA is small or was closed when you were a child, treatment may not be necessary.
If the PDA is medium-sized, large or causes blood flow problems or other complications, you may need surgery to close it. Open surgery is rarely necessary. Surgeons can close most PDAs in adults using less invasive, catheter-based techniques. Working through a small incision in the chest, the surgeon can close the PDA using a suture, patch or metal clip.

Follow-up Care

If you undergo surgery to close a PDA, your cardiologist may recommend that you temporarily limit physical activity. You may also need to take antibiotics for six months after surgery to prevent an infection of the heart called infective endocarditis. Be sure to follow up with your cardiologist regularly for monitoring.
If you have pulmonary hypertension caused by a PDA, it may be necessary to limit physical activity.
If you have a small PDA or a PDA that was successfully closed in the past, it’s unlikely that you will need additional treatment, and your cardiologist may not place any limits on physical activity. Continue to follow up with your cardiologist regularly for monitoring.