A ductus arteriosus is a vascular fetal structure that usually closes in the first 48 hours after birth.
Persistence of the ductus arteriosus can result in heart failure, increased pulmonary pressures, and endarteritis.
The incidence and sequelae of a patent ductus arteriosus (PDA) are more significant in premature infants than infants born at full-term.
Clinical history and presentation can vary significantly depending on age of the child and the size of the ductus. Patients may be entirely asymptomatic or have signs and symptoms of heart failure and hemodynamic instability.
Treatment options vary depending on the age of the patient and the size of the ductus. Practice may vary significantly between institutions.
Patent ductus arteriosus (PDA) describes the persistence of a fetal structure, known as the ductus arteriosus, after birth. This vascular structure, which connects the main pulmonary artery to the aorta, allows blood to bypass the lungs in utero. In term infants it functionally closes, usually in the first 48 hours of life.
History and exam
- tachypnea/shortness of breath (SOB)
- failure to thrive
- exercise intolerance
- widened pulse pressure
- machine-like continuous murmur/Gibson murmur in children born at term
- low diastolic BP
- increased respiratory symptoms with upper respiratory infection
- murmur heard only during systole
- hyperdynamic precordium
- systolic thrill
- third heart sound heard at apex
- mid-diastolic rumble heard at apex
- bounding peripheral pulses
- pulmonary rales
Assistant Professor, Pediatric Cardiology
Ann & Robert H. Lurie Children's Hospital of Chicago
Northwestern University Feinberg School of Medicine
JTJ declares that she has no competing interests.
Associate Professor, Pediatrics
University of Utah
Salt Lake City
NMP declares that she has no competing interests.
Dr Joyce T. Johnson and Dr Nelangi M. Pinto would like to gratefully acknowledge Dr Anji T. Yetman, a previous contributor to this monograph. ATY declares that she has no competing interests.
Department of Cardiology
Royal Children's Hospital
MC declares that he has no competing interests.
Texas Tech University Health Sciences Center (TTUHSC)
RB declares that he has no competing interests.
Professor of Pediatrics
The Children's Hospital
HMS declares that he has no competing interests.
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