| Diagnosis of patent ductus arteriosus (PDA) in premature babies | 1802.00000000000 | Diagnosis of patent ductus arteriosus (PDA) in premature babies | Diagnosis of patent ductus arteriosus (PDA) in premature babies | D | English | Neonatology;Cardiology | Premature;Newborn (0-28 days);Baby (1-12 months) | Heart | Cardiovascular system | NA | Prenatal
Adult (19+) | NA | | 2009-10-31T04:00:00Z | | Patrick McNamara, MB, BCh, BAO, FRCPCAndrew James, MBChB, FRACP, FRCPC | | | | 10.4000000000000 | 54.0000000000000 | 703.000000000000 | | Flat Content | Health A-Z | <p>Read about patent ductus arteriosus (PDA) in premature infants. Often, the first sign of a PDA comes from the sound of the baby's heart and blood flow. </p> | <p>The first sign of patent ductus arteriosus (PDA) often comes from the sound of the baby's heart and blood flow. Additional diagnostic testing such as blood gases measurement and X-rays will help to diagnose PDA.</p> | | <h2>Key points</h2>
<ul><li>The first sign of a PDA comes from the sound of the baby's heart and blood throw, through a stethoscope.</li>
<li>Other signs of PDA include apnea, jerky heart beat pulses in the leg or wrist, prominent pulses, and visible increased activity of the heart as seen on the chest wall.</li>
<li>Diagnostic tests include blood gases measurement, X-rays and two-dimensional echocardiography.</li></ul> | <p>In the womb, oxygen comes from the mother. As there is no need for blood to pass through the lungs of the fetus, the blood is diverted away from the lungs, to the rest of the body, by an artery called the ductus arteriosus.</p><p>Once a baby is born, their first breath initiates changes in the function of the heart. Suddenly filling with air, the lungs expand, the blood vessels within the lungs relax, and blood flow increases, allowing for gas exchange. As blood flow to the umbilical cord and placenta drops to nothing, the ductus arteriosus begins to close rapidly. Under normal circumstances, the ductus arteriosus is completely sealed and replaced with scar tissue in a few weeks, never to open again.</p><p>With some premature babies, this process of closure either does not happen at all or does not happen sufficiently, leaving a small opening. As a result, normal blood flow is affected. This condition is called patent ductus arteriosus (PDA). “Patent,” in this context, means “open.”</p><h2>How PDA is diagnosed</h2><p>Often, the first sign of a PDA comes from the sound of the baby’s heart and blood flow heard through an ordinary stethoscope. Typically, a PDA will sound like a continuous murmur, though depending on how and how much the ductus arteriosus has closed, the murmur may be short or long and regular. The audible murmurs are actually the sounds of blood flow turbulence. At times, however, a PDA can be silent; if the opening is large enough, there may not be any turbulence to cause a detectable murmur.</p><p>Other signs of PDA include apnea, jerky heart beat pulses that can appear in the leg or wrist, prominent pulses, and visible increased activity of the heart as seen on the chest wall.</p><p>A PDA diverts blood that has received oxygen already back into the lungs. This means that there is not enough oxygenated blood in the vascular system. It also means that there will be a corresponding increase in carbon dioxide levels in the blood. This increase will be detected because a baby’s blood gases are continuously monitored in the Neonatal Intensive Care Unit (NICU) with pulse oximetry.</p><p>As the heart must work abnormally hard to oxygenate the body, it tries to compensate by pumping harder, which may lead to an increase in its size. X-rays will often reveal an enlarged heart.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Patent ductus arteriosus X-ray</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Patent_ductus_arteriosus_XRAY_MEDIMG_PHO_EN.png" alt="X-ray of normal heart and x-ray of enlarged heart due to patent ductus arteriosus" />
<figcaption class="asset-image-caption">In patent ductus arteriosus, the heart works hard to try and increase the volume of oxygenated blood moving through in the system, and the chambers of the heart may become enlarged.</figcaption> </figure>
<p>The abnormal blood flow may also have other effects which can be detected with X-rays and other diagnostic imaging equipment. For example, a wide-open PDA may actually increase pulmonary blood flow, creating an elevated blood pressure in the lungs and a corresponding weakness in the left ventricle of the heart. In more severe cases, this abnormal blood flow will cause pulmonary edema, or build-up of fluid in the lungs, making breathing more difficult. Under most circumstances, these effects can be observed on an X-ray.</p><p>Two-dimensional echocardiography (2D echo), an imaging technique similar to an ultrasound, can provide more detailed information about the PDA, including its size and the amount of blood flowing through it and how well it has responded to therapy.</p><h3>More information</h3><ul><li>
<a href="/Article?contentid=1617&language=English">Patent ductus arteriosus (PDA) in premature babies</a></li><li>
<a href="/Article?contentid=1839&language=English">Treatment of patent ductus arteriosus (PDA) in premature babies</a></li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/Patent_ductus_arteriosus_XRAY_MEDIMG_PHO_EN.png | Diagnosis of patent ductus arteriosus (PDA) in premature babies | | False | | | | | |
