​Patent Ductus Arteriosus

Patent ductus arteriosus (PDA) is a common congenital birth defect in which the temporary blood vessel, called ductus arteriosus, fails to close soon after birth.

In a healthy body, the blood travels from the heart to the lungs via the pulmonary artery for oxygenation. This oxygen-rich blood is then pumped to the rest of the body through the aorta. In the womb, instead of passing through the lungs, the blood flows directly from the pulmonary artery to the aorta, with the help of the ductus arteriosus, as the foetus gets its oxygenated blood from the mother. When the dustus arteriosus remains open after birth, the oxygen –rich blood from the aorta merges with oxygen-poor blood in the pulmonary artery causing complications such as pulmonary hypertension (increase in blood pressure in the lungs)

The exact cause of PDA is unknown, but some risk factors associated with it include:

  • Premature birth

  • History of PDA in family

  • Rubella (German measles) infection in mother during pregnancy

  • High altitude birth

Symptoms of PDA can be from mild to severe, depending upon the size of the opening and whether the baby is premature or full-term. A small PDA can go undetected for some time due to lack of symptoms, while a large PDA can cause heart failure in new-borns. Most common symptoms, during infancy or childhood, include:

  • Sweating with crying or eating

  • Rapid and heavy breathing

  • Rapid heart rate

  • Fatigue

  • Poor growth

  • Little interest in feeding​

Contact our Paediatric Cardiologists at the Children's Hospital Service Line at The Aga Khan University Hospital, if you notice any of the above mentioned symptoms in your baby or older child.​
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​

The doctor might suspect a PDA during physical examination of your new-born. PDA can be detected by a heart murmur (an extra or unusual sound in the heartbeat) when the doctor listens to your child’s heart using a stethoscope. For further diagnosis, the doctor may ask you to get the following tests done:

  • Echocardiogram in which sound waves are used to produce images of the heart. The doctor studies the images to see if the heart chambers are enlarged, if there is any abnormality in the blood flow and to identify any other heart defects. This is the most common way to diagnose PDA.

  • ECG (Electrocardiogram) in which the electrical activity of the heart is recorded to detect any heart defect or rhythm problems

  • Chest X-ray to see the conditions of your baby’s heart and lungs​

It can be very stressful for a parent to discover any kind of disorder in their child. However, PDAs are fairly common in new-borns and most often they are not a cause of concern if caught early and treated promptly.​​

Your child’s treatment depends on their age and the general overall health. If the opening in the ductus arteriosus is very small, your child may not require any treatments as the opening closes itself as the child grows. You will have to bring your child for regular check-ups so that the doctor can monitor the PDA. In case the ductus arteriosus fails to close or is too large to close with age, the doctor may prescribe the following treatments:

  • Medications for premature babies, to aid the closing of a PDA, by blocking the chemicals that keep the PDA open. Medications do not help in closing a PDA in full-term babies

  • Open-heart surgery in which a small incision will be made on your child’s chest, between the ribs, to gain access to the heart and close the PDA using stitches or a clips. Your child will have to stay in the hospital for a few days so that their condition can be monitored. It can take a few weeks for your child to recover from this surgery. Your child may also be prescribed medications to prevent any infection post-surgery

  • Catheter procedures in which a thin tube (catheter) is used to place a coil or a plug in the PDA in order to close it. The catheter is inserted in a blood vessel in the groin and moved up to the heart. This is done on an outpatient basis and requires minimum hospital stay. Complications that can arise from this procedure include bleeding, infection or dislocation of the plug or coil. Catheter procedure cannot be performed in premature babies​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​
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​​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.