Patent ductus arteriosus (PDA)

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Complications

By Mayo Clinic staff

A small patent ductus arteriosus may not cause any complications. Larger defects that are untreated could cause:

  • High blood pressure in the lungs (pulmonary hypertension). If too much blood continues to circulate through the heart's main arteries through a patent ductus arteriosus, it can lead to pulmonary hypertension. Pulmonary hypertension can cause permanent lung damage. A large patent ductus arteriosus can lead to Eisenmenger's syndrome, an irreversible type of pulmonary hypertension.
  • Heart failure. A patent ductus arteriosus can eventually cause the heart to enlarge due to extra blood flow and may cause the muscle to weaken, leading to heart failure. Heart failure is a chronic condition in which the heart can't pump effectively.
  • An infection of the heart (endocarditis). People with structural heart problems, such as a patent ductus arteriosus, are at a higher risk of infectious endocarditis than is the general population. Infectious endocarditis is an inflammation of the inner lining of the heart caused by a bacterial infection.
  • Irregular heartbeat (arrhythmia). Enlargement of the heart due to a patent ductus arteriosus increases the risk of arrhythmias. This increased risk usually occurs only with a large patent ductus arteriosus.

Patent ductus arteriosus and pregnancy
Pregnancy is often a concern for women born with a heart defect. Most women with a small patent ductus arteriosus can tolerate pregnancy without any problems. However, having a larger defect or having complications, such as heart failure, arrhythmias or pulmonary hypertension, can increase your risk of complications during pregnancy. A woman with Eisenmenger's syndrome shouldn't become pregnant because it can endanger the woman's life.

Anyone with a congenital heart defect, repaired or not, who is considering starting a family should carefully discuss it beforehand with his or her doctor. In some cases, preconception consultations with doctors who specialize in cardiology, genetics and high-risk obstetric care are needed. Some heart medications can cause serious problems for a developing baby and may need to be stopped or adjusted before you become pregnant.

References
  1. Patent ductus arteriosus. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/pda/. Accessed Nov. 9, 2011.
  2. Patent ductus arteriosus. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/pediatrics/congenital_cardiovascular_anomalies/patent_ductus_arteriosus_pda.html?qt=patent%20ductus%20arteriosus&alt=sh. Accessed Nov. 9, 2011.
  3. Schneider DJ, et al. Patent ductus arteriosus. Circulation. 2006;114:1873.
  4. Doyle T, et al. Clinical manifestations and diagnosis of patent ductus arteriosus. http://www.uptodate.com/home/index.html. Accessed Nov. 9, 2011.
  5. Phillips III JB, et al. Pathophysiology, clinical manifestations, and diagnosis of patent ductus arteriosus in premature infants. http://www.uptodate.com/home/index.html Accessed Nov. 9, 2011.
  6. Miyamoto SD, et al. Cardiovascular diseases. In: Hay WW, et al, eds. Current Diagnosis & Treatment: Pediatrics. 20th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=6582787. Accessed November 13, 2011.
  7. Patent ductus arteriosus (PDA). American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Patent-Ductus-Arteriosis-PDA_UCM_307032_Article.jsp#.Trsm4fJUFI4. Accessed Nov. 9, 2011.
  8. Warnes CA, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Journal of the American College of Cardiology. 2008;52:e143. Accessed Nov. 9, 2011.
  9. Clyburn RI, et al. Patent ductus arteriosus: Evidence for and against treatment. Journal of Pediatrics. 2007;150:216.
  10. Hammerman C, et al. Ductal closure with paracetamol: A surprising new approach to patent ductus arteriosus treatment. Pediatrics. In Press. Accessed Nov. 9, 2011.
  11. Preconception care questions and answers. U.S. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/preconception/QandA.htm. Accessed Nov. 14, 2011.
DS00631 Dec. 22, 2011

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