Patent Ductus Arteriosus (PDA) March of Dimes Fall 2008 November 11, 2008

Background information A congenital heart defect (problems present at birth) An artery called the ductus arteriosus leads blood from the heart away from the lungs in the baby during pregnancy Under normal circumstances, a newborn’s ductus arteriosus closes with a few hours or a few days of birth

How the heart works

What is Patent Ductus Arteriosus Sometimes the newborn’s ductus arteriosus does not close soon enough after birth. This is PDA.

Causes No specific known causes Genes may play a role Side effect of other CHDs

Occurrence Around 3000 diagnosed each year in the USA More common in premature and/or hypoxic infants (lack of bradykinin) More likely in babies with Down syndrome More likely if mother had German measles (rubella) during pregnancy Twice as common in girls as boys

Signs and Symptoms Tachycardia Sweating Shortness of breath, fast breathing Heart murmur Tired easily Poor feeding and weight gain Enlargement of heart

Diagnosis Diagnosis begins with heart murmur Small PDA may not be diagnosed until later childhood In premature babies, heart murmur may not be detected, so diagnosis begins with fast breathing Two methods to diagnose: ◦ Echocardiogram (ultrasound picture) ◦ Electrocardiogram (electrical signals from heart)

Treatment and Outcomes An otherwise healthy baby’s PDA may eventually go away If other defects slowing blood flow are present, the PDA may be wanted to keep open until surgery can be performed If the opening is too large and does not close by the age of 1 or 2, it will need to be treated Treatment methods: medicine, catheter based, surgery

Treatments (cont’d) Medicines used to close: indomethasin (in premature babies) and ibuprofen Cardiac catheterization Surgery is used when babies are too small for them to receive catheterization and is done on babies older than 6 months without other health problems from the PDA

What is March of Dimes Doing? Not specifically for PDA, but scientists funded by March of Dimes are working on linking genes and environmental factors to congential heart defects and also brain injuries to prevent and treat them.

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