Diagnosis

Your child's doctor might suspect a patent ductus arteriosus based on your child's heartbeat. PDA can cause a heart murmur that the doctor can hear through a stethoscope.

If the doctor suspects a heart defect, he or she might request one or more of the following tests:

  • Echocardiogram. Sound waves produce images of the heart that can help the doctor identify a PDA, see if the heart chambers are enlarged, and judge how well the heart is pumping. This test also helps the doctor evaluate the heart valves and detect other potential heart defects.
  • Chest X-ray. An X-ray image helps the doctor see the condition of your baby's heart and lungs. An X-ray might reveal conditions other than a heart defect, as well.
  • Electrocardiogram (ECG). This test records the electrical activity of the heart, which can help the doctor diagnose heart defects or rhythm problems.
  • Cardiac catheterization. This test isn't usually necessary for diagnosing a PDA alone, but it might be done to examine other congenital heart defects found during an echocardiogram or if a catheter procedure is being considered to treat a PDA. A thin, flexible tube (catheter) is inserted into a blood vessel at your child's groin or arm and guided through it into the heart. Through catheterization, the doctor can do procedures to close the patent ductus arteriosus.

Treatment

Treatments for patent ductus arteriosus depend on the age of the person being treated. Options might include:

  • Watchful waiting. In a premature baby, a PDA often closes on its own. The doctor will monitor your baby's heart to make sure the open blood vessel is closing properly. For full-term babies, children and adults who have small PDAs that aren't causing other health problems, monitoring might be all that's needed.
  • Medications. In a premature baby, nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen (Advil, Infant's Motrin, others) or indomethacin (Indocin) — might be used to help close a PDA. NSAIDs block the hormonelike chemicals in the body that keep the PDA open. NSAIDs won't close a PDA in full-term babies, children or adults.
  • Open-heart surgery. If medications aren't effective and your child's condition is severe or causing complications, open-heart surgery might be recommended. A surgeon makes a small cut between your child's ribs to reach your child's heart and repair the open duct using stitches or clips.

    After the surgery, your child will remain in the hospital for several days for observation. It usually takes a few weeks for a child to fully recover from open-heart surgery. Open-heart surgery might also be recommended for adults who have a PDA that's causing health problems. Possible risks include hoarseness, bleeding, infection and a paralyzed diaphragm.

  • Catheter procedures. Premature babies are too small for catheter procedures. However, if your baby doesn't have PDA-related health problems, the doctor might recommend waiting until the baby is older to do a catheter procedure to correct the PDA. Catheter procedures can also be used to treat full-term babies, children and adults.

    In a catheter procedure, a thin tube (catheter) is inserted into a blood vessel in the groin and threaded up to the heart. Through the catheter, a plug or coil is inserted to close the ductus arteriosus.

    If the procedure is done on an outpatient basis, your child probably won't stay overnight in the hospital. Complications from catheter procedures include bleeding, infection, or movement of the plug or coil from where it was placed in the heart.

Preventive antibiotics

In the past, people who've had a PDA were advised to take antibiotics before dental work and certain surgical procedures to prevent a heart infection (infective endocarditis). Today, preventive antibiotics are no longer recommended for most people with a patent ductus arteriosus.

Your child may need to take preventive antibiotics the first six months after a catheter repair procedure or if there's still damage after the repair. Talk to your doctor about whether your child needs to take antibiotics before any procedures.

Lifestyle and home remedies

If you or your child has a congenital heart defect or has had surgery to correct one, you might have some concerns about aftercare. Here are some issues you might be thinking about:

  • Preventing infection. For most people who have a patent ductus arteriosus, regularly brushing and flossing teeth and regular dental checkups are the best ways to help prevent infection.
  • Exercising and play. Parents of children who have congenital heart defects often worry about the risks of rough play and vigorous activity, even after successful treatment. Although some children might need to limit the amount or type of exercise, most people who have patent ductus arteriosus will lead normal lives. Your child's doctor can advise you about which activities are safe for your child.

Preparing for your appointment

A patent ductus arteriosus might be found while your baby is in the hospital after birth or it might be discovered later, sometimes because of a heart murmur. If your child's pediatrician suspects a PDA, he or she might refer you to a doctor who specializes in treating children with heart conditions (pediatric cardiologist).

Here's some information to help you get ready for your appointment.

What you can do

  • Be aware of pre-appointment restrictions. When you make the appointment, ask if there's anything you need to do in advance — such as restrict your child's diet.
  • Write down your child's symptoms, including any that might seem unrelated to patent ductus arteriosus or another heart defect.
  • Bring copies of past medical records, including reports from previous surgeries or imaging tests.
  • List medications, vitamins or supplements that your child takes.
  • Write down questions to ask the doctor.

For patent ductus arteriosus, questions to ask include:

  • Is the PDA causing problems?
  • What tests are necessary?
  • Will my child need surgery?
  • What are the alternatives to the primary approach that you're suggesting?
  • Should my child see a cardiologist specializing in congenital heart defects?
  • Is this condition inherited? If I have another child, how likely is he or she to have a PDA?
  • Do I need to restrict my child's activities?
  • Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions, as well.

What to expect from your doctor

The doctor is likely to ask you a number of questions, such as:

  • When did you notice your child's symptoms?
  • Have the symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve the symptoms?
  • What, if anything, seems to worsen the symptoms?
  • What medications has your child taken to treat the condition? What surgeries has your child had?

Patent ductus arteriosus (PDA) care at Mayo Clinic

Dec. 16, 2014
References
  1. What is patent ductus arteriosus? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/pda/. Accessed Oct. 20, 2014.
  2. Patent ductus arteriosus. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/pediatrics/congenital_cardiovascular_anomalies/patent_ductus_arteriosus_pda.html?qt=patent%20ductus%20arteriosus&alt=sh. Accessed Oct. 20, 2014.
  3. Doyle T, et al. Clinical manifestations and diagnosis of patent ductus arteriosus. http://www.uptodate.com/home. Accessed Oct. 20, 2014.
  4. Doyle T, et al. Management of patent ductus arteriosus. http://www.uptodate.com/home. Accessed Oct. 20, 2014.
  5. Planning for pregnancy. Centers for Disease Control and Prevention. http://www.cdc.gov/preconception/planning.html. Accessed Oct. 22, 2014.
  6. Riggin EA. Decision Support System. Mayo Clinic, Rochester, Minn. July 10, 2014.