How To Diagnose Patent Ductus Arteriosus & What Is The Best Medicine For It?

The murmur, along with symptoms of heart failure in a premature infant is a classic symptom of PDA that leads to the diagnose of patent ductus arteriosus.1

Patent ductus arteriosus symptoms vary with the size of the defect and the diagnosis is based on the baby’s symptoms and health history.2

Prostaglandin E2 (PGE2) is a substance that prevents the hormone that keeps the duct open and help close patent ductus arteriosus3,4

How To Diagnose Patent Ductus Arteriosus?

The ductus arteriosus is a central vascular shunt connecting the major two arteries, the pulmonary artery and the aorta allowing the oxygenated blood to flow from the placenta to the lungs. Failure of cases leads to uninflated fetal lungs.

The incidence of patent ductus arteriosus is often associated with the degree of premature births. Preterm babies have a higher occurrence of respiratory distress syndrome, prolonged rupture of membranes, and PDA’s. A doctor may diagnose your child’s PDA after listening to your child’s heart.1

Your child will have a systolic murmur when the ductus shunt is large. Symptoms of PDA include shortness of breath, decreased oxygen saturation, and higher oxygen support. This condition is diagnosed through a chest X-ray to show the stigmata of pulmonary edema. The other diagnostic tests include

Echocardiogram– Otherwise known as cardiac echo, it checks the heart’s chambers and valves pumping blood through the heart. They produce sound waves to diagnose the enlarged heart and help the doctor detect potential heart defects.

Electrocardiogram– It records electrical signals in your heart to check how your heart is functioning and rhythm problems. EKG also tests for enlarged heart in infants.

Bioengineering and analytical techniques have also been developed to monitor and identify patent ductus arteriosus in premature babies. Various other approaches include pulse oximetry information, transthoracic electric signals, and spectrometry.2

What Is The Best Medicine For Patent Ductus Arteriosus?

Medicines work best for preterm infants and newborns. Ductus produces Prostaglandin E1 that keeps the PDA open. They receive non-steroidal anti-inflammatory drugs such as indomethacin, ibuprofen, Advil, Motrin, and a few others through IV to help close PDA. When NSAIDs are administered within 10-14 days, it produces effective results.

However, medicines are often based on the clinical status of the infant and the severity of the condition. In a newborn, PDA has an increased risk to close on its own. Your healthcare provider may suggest allowing more time to resolve by itself unless the heart problem is under control. However, if the symptoms are severe and have unlikely chances of PDA to close on its own, medical or surgical treatments will be required.

If significant respiratory trouble or damaged systemic oxygen delivery is present, treatment is highly important. Researchers performed a meta-analysis of randomized examinations that compared various medical strategies and showed no treatment is effective for the closure of a hemodynamically significant patent ductus arteriosus.3,4

Patent Ductus Arteriosus is a common congenital heart defect that occurs in several newborns every year in the United States. It occurs more common in preterm infants at an average of 8 out of 1000 babies. It is vital to identify patent ductus arteriosus because it can lead to congestive heart failure.

A pediatrician will usually diagnose the condition after listening to your child’s irregular heart rhythm. Most cases of PDA produce a murmuring sound due to fast breathing, shortness of breath, and difficulty in breathing.

References:

  1. Gillam-Krakauer, Maria, and Jeff Reese. “Diagnosis and Management of Patent Ductus Arteriosus.” NeoReviews, U.S. National Library of Medicine, July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6269146/.
  2. Ellis, Mary Ellen. “Patent Ductus Arteriosus: Causes, Symptoms, and Diagnosis.” Healthline, Healthline Media, 15 Aug. 2018, www.healthline.com/health/patent-ductus-arteriosus.
  3. “Which Medications Are Used to Treat Patent Ductus Arteriosus (PDA)?” Latest Medical News, Clinical Trials, Guidelines – Today on Medscape, 23 Mar. 2020, www.medscape.com/answers/891096-69182/which-medications-are-used-to-treat-patent-ductus-arteriosus-pda.
  4. NEJM Journal Watch: Summaries of and Commentary on Original Medical and Scientific Articles from Key Medical Journals, www.jwatch.org/na46425/2018/05/08/what-best-treatment-symptomatic-patent-ductus-arteriosus.

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