Paediatrics: Persistent ductus arteriosus

2021-03-05 12:00 AM

PDA is common and seen in 1–2/1000 live births. Sometimes it follows on from a preterm delivery. It is defi ned as a duct still being present 1mth after the date that the child should have been born.

Persistent ductus arteriosus

PDA is common and seen in 1–2/1000 live births. Sometimes it follows on from a preterm delivery. It is defined as a duct still being present 1mth after the date that the child should have been born.

Clinical features

PDA results in a low diastolic pressure, due to blood flowing back into the pulmonary artery. There may be heart failure (breathlessness).

Examination

  • A wide pulse pressure or bounding peripheral pulses.
  • A continuous or machinery murmur in the left infraclavicular area.

Prognosis 

The majority of defects will close spontaneously.

Management

  • Medical: diuretics.
  • Cardiac catheter: device closure usually at 1yr.
  • Surgical: ligation (rarely).