Overview

What Is Patent Ductus Arteriosus ?

Patent ductus arteriosus (PDA) is a heart problem that occurs soon after birth in some babies. In PDA, there is an abnormal circulation of blood between two of the major arteries near the heart. Before birth, the two major arteries—the aorta and the pulmonary artery—are normally connected by a blood vessel called the ductus arteriosus, which is an essential part of the fetal circulation.

After birth, the vessel is supposed to close within a few days as part of the normal changes occurring in the baby's circulation. In some babies, however, the ductus arteriosus remains open (patent). This opening allows blood to flow directly from the aorta into the pulmonary artery, which can put a strain on the heart and increase the blood pressure in the lung arteries.

A PDA is a type of congenital heart defect. A congenital heart defect is any type of heart problem that is present at birth. If your baby has a PDA, but has an otherwise normal heart, the PDA may shrink and go away completely, or it may need to be treated to close it. But, if your baby is born with certain types of heart defects that decrease blood flow from the heart to the lungs or the body, medicine may be given to keep the ductus arteriosus open to maintain blood flow and oxygen levels until corrective surgery for the heart defect(s) can be performed.

About 3,000 infants are diagnosed with PDA each year in the United States. It is more common in premature infants (babies born too early) but does occur in full-term infants. Premature babies with PDA are more vulnerable to its effects. PDA is twice as common in girls as in boys.

The next section, How the Heart Works, provides a more detailed description of a heart with a PDA compared to a normal heart. See that section for a more detailed description of the anatomy and circulation of a normal heart.

Treatment for PAD :-

Physical Activity :

The most effective treatment for PAD is regular physical activity. Your doctor may recommend a program of supervised exercise training for you. You may have to begin slowly, but simple walking regimens, leg exercises and treadmill exercise programs three times a week can result in decreased symptoms in just four to eight weeks. Exercise for intermittent claudication takes into account the fact that walking causes pain

Diet :

Many PAD patients have elevated cholesterol levels. A diet low in saturated fat, trans fat and cholesterol can help lower blood cholesterol levels, but medication may be necessary to maintain the proper cholesterol levels.

Smoking Cessation :

Tobacco smoke greatly increases your risk for PAD and your risk for heart attack and stroke. Smokers may have four times the risk of developing PAD than nonsmokers. Stop smoking. It will help to slow the progression of PAD and other heart-related diseases

Medication :-

You may be prescribed high blood pressure and/or cholesterol-lowering medications. It's important to make sure that you take the medication as recommended by your healthcare professional. Not following directions increases your risk for PAD, as well as heart attack and stroke.

Medications that your doctor may prescribe to help improve the distance you can walk include cilostazol and pentoxifylline.

In addition, you may be prescribed antiplatelet medications (aspirin and clopidogrel) to help prevent blood clots


PAD risk factors you can control :

Cigarette smoking — Smoking is a major risk factor for PAD. Smokers may have four times the risk of PAD than nonsmokers. Our guide to quitting smoking can help you.

Physical inactivity — Physical activity increases the distance that people with PAD can walk without pain and also helps decrease the risk of heart attack or stroke. Supervised exercise programs are one of the treatments for PAD patients.

High blood cholesterol — High cholesterol contributes to the build-up of plaque in the arteries, which can significantly reduce the blood's flow. This condition is known as atherosclerosis. Managing your cholesterol levels is essential to prevent or treat PAD.

Obesity — People with a Body Mass Index (BMI) of 25 or higher are more likely to develop heart disease and stroke even if they have no other risk factors. Calculate your BMI and learn healthy ways to manage your weight

Diabetes mellitus — Having diabetes puts you at greater risk of developing PAD as well as other cardiovascular diseases. Learn more about the risks and how to manage diabetes

High blood pressure — It's sometimes called "the silent killer" because it has no symptoms. Work with your healthcare professionals to monitor and control your blood pressure


How the Heart Works ?

Your child’s heart is a muscle about the size of his or her fist. It works like a pump and beats 100,000 times a day. The heart has two sides, separated by an inner wall called the septum. The right side of the heart pumps blood to the lungs to pick up oxygen. Then, oxygen-rich blood returns from the lungs to the left side of the heart, and the left side pumps it to the body. The heart has four chambers and four valves and is connected to various blood vessels. Veins are the blood vessels that carry blood from the body to the heart. Arteries are the blood vessels that carry blood away from the heart to the body.

The illustration shows a cross-section of a healthy heart and its inside structures. The blue arrow shows the direction in which oxygen-poor blood flows from the body to the lungs. The red arrow shows the direction in which oxygen-rich blood flows from the lungs to the rest of the body.

Heart Chambers :

The heart has four chambers or "rooms."

The atria (AY-tree-uh) are the two upper chambers that collect blood as it comes into the heart.
The ventricles (VEN-trih-kuls) are the two lower chambers that pump blood out of the heart to the lungs or other parts of the body.

Heart Valves :

Four valves control the flow of blood from the atria to the ventricles and from the ventricles into the two large arteries connected to the heart.

The tricuspid (tri-CUSS-pid) valve is in the right side of the heart, between the right atrium and the right ventricle.
The pulmonary (PULL-mun-ary) valve is in the right side of the heart, between the right ventricle and the entrance to the pulmonary artery, which carries blood to the lungs.
The mitral (MI-trul) valve is in the left side of the heart, between the left atrium and the left ventricle.
The aortic (ay-OR-tik) valve is in the left side of the heart, between the left ventricle and the entrance to the aorta, the artery that carries blood to the body.

Valves are like doors that open and close. They open to allow blood to flow through to the next chamber or to one of the arteries, and then they shut to keep blood from flowing backward.

When the heart's valves open and close, they make a "lub-DUB" sound that a doctor can hear using a stethoscope :

The first sound—the “lub”—is made by the mitral and tricuspid valves closing at the beginning of systole (SIS-toe-lee). Systole is when the ventricles contract, or squeeze, and pump blood out of the heart.

he second sound—the “DUB”—is made by the aortic and pulmonary valves closing at beginning of diastole (di-AS-toe-lee). Diastole is when the ventricles relax and fill with blood pumped into them by the atria.


Arteries :

The arteries are major blood vessels connected to your heart :

The pulmonary artery carries blood pumped from the right side of the heart to the lungs to pick up a fresh supply of oxygen.
The aorta is the main artery that carries oxygen-rich blood pumped from the left side of the heart out to the body.
The coronary arteries are the other important arteries attached to the heart. They carry oxygen-rich blood from the aorta to the heart muscle, which must have its own blood supply to function.


Veins :

The veins are also major blood vessels connected to your heart :

The pulmonary veins carry oxygen-rich blood from the lungs to the left side of the heart so it can be pumped out to the body.
The vena cava is a large vein that carries oxygen-poor blood from the body back to the heart.

For more information on how a healthy heart works, see the Diseases and Conditions Index article on How the Heart Works. This article contains animations that show how your heart pumps blood and how your heart’s electrical system works.

Diagnosis :

PDA is diagnosed using non-invasive techniques:

Electrocardiography (ECG):-

electrodes are used to record the electrical activity of the heart and can detect cardiac arrhythmias associated with PDA.

Chest X-ray :-

might reveal the structure of the infant's heart and the size.

Echocardiography:-

sound waves are used to capture the motion of the heart. It is the main diagnostic tool in detecting PDA.

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