pediatrics
Patent Ductus Arteriosus (PDA)
Introduction
Patent ductus arteriosus (PDA) is a persistence of the fetal connection (ductus arteriosus) between the aorta and pulmonary artery after birth. In the absence of other structural heart abnormalities or elevated pulmonary vascular resistance, shunting in the PDA will be left to right (from aorta to pulmonary artery). Symptoms may include failure to thrive, poor feeding, tachycardia, and tachypnea. A continuous murmur at the upper left sternal border and bounding pulses are common. Diagnosis is by echocardiography. Administration of a cyclo-oxygenase inhibitor (ibuprofen lysineorindomethacin) with or without fluid restriction may be tried in preterm infants with a significant shunt, but this therapy is not effective in term infants or older children with PDA. If the connection persists, surgical or catheter-based correction is indicated. (See also Overview of Congenital Cardiovascular Anomalies .) 1200 g). About one third of PDAs will close spontaneously, even in extremely low birth weight infants. When persistent in preterm infants, a significant PDA can result in Heart failure , exacerbation of lung disease of prematurity, pulmonary hemorrhage, renal insufficiency, feeding intolerance, 