Przetrwały przewód tętniczy
Objawy

Przetrwały przewód tętniczy (PDA) to wada serca charakteryzująca się utrzymaniem drożnego połączenia między aortą a tętnicą płucną, które fizjologicznie powinno zamknąć się w pierwszych dniach lub tygodniach życia. Kliniczny obraz PDA zależy od wielkości przewodu: mały PDA jest często bezobjawowy, średni może powodować umiarkowane objawy, a duży prowadzi do istotnych zaburzeń hemodynamicznych i objawów niewydolności serca, takich jak tachypnoe, tachykardia, szmer ciągły („maszynowy”), trudności w karmieniu i zaburzenia wzrastania. U wcześniaków objawy niewydolności serca pojawiają się wcześniej i są bardziej nasilone. Nieleczony duży PDA wiąże się z poważnymi powikłaniami, w tym nadciśnieniem płucnym, zespołem Eisenmengera, niewydolnością serca, infekcyjnym zapaleniem wsierdzia oraz przewlekłym uszkodzeniem płuc, a także znaczną śmiertelnością (20% do 20 roku życia, 42% do 45 roku życia, 60% do 60 roku życia).

Objawy przetrwałego przewodu tętniczego

Przetrwały przewód tętniczy (ang. Patent Ductus Arteriosus, PDA) to wada serca polegająca na utrzymywaniu się drożnego połączenia między aortą a tętnicą płucną, które fizjologicznie powinno zamknąć się w ciągu pierwszych dni lub tygodni po urodzeniu. Objawy tej wady zależą od wielkości otworu i wieku pacjenta.12

Nasilenie objawów w zależności od wielkości PDA

Ciężkość objawów przetrwałego przewodu tętniczego jest ściśle związana z rozmiarem utrzymującego się połączenia między aortą a tętnicą płucną.3 Można wyróżnić różne scenariusze kliniczne:

  • Mały PDA: Często nie wywołuje żadnych objawów poza szmerem serca wykrywanym podczas osłuchiwania stetoskopem.45
  • Średni PDA: Może powodować łagodne lub umiarkowane objawy wynikające ze zwiększonego przepływu krwi przez płuca.2
  • Duży PDA: Prowadzi do znacznych zaburzeń hemodynamicznych i objawów niewydolności serca, które mogą pojawić się wkrótce po urodzeniu.16

Objawy u niemowląt

Dzieci z dużym PDA często prezentują objawy już w pierwszych tygodniach lub miesiącach życia. Typowe objawy u niemowląt obejmują:76

U wcześniaków z PDA dodatkowo może wystąpić pogorszenie stanu oddechowego po początkowej poprawie i trudności z odłączeniem od respiratora.14 Objawy niewydolności serca pojawiają się wcześniej u wcześniaków niż u niemowląt urodzonych o czasie i mogą być bardziej nasilone.5

Objawy u starszych dzieci

U starszych dzieci z nieleczonym PDA mogą występować:1115

  • Trudności z tolerancją wysiłku fizycznego16
  • Nawracające infekcje dróg oddechowych, w tym zapalenia płuc717
  • Zaburzenia wzrastania – wolniejszy rozwój fizyczny w porównaniu do rówieśników18
  • Duszność podczas aktywności fizycznej19

Objawy u osób dorosłych

Osoby, u których PDA nie został zdiagnozowany w dzieciństwie, mogą prezentować w wieku dorosłym:1720

Progresja przetrwałego przewodu tętniczego

Naturalny przebieg nieleczonego PDA zależy od wielkości przetrwałego przewodu oraz wieku pacjenta.2324

Spontaniczne zamknięcie

W niektórych przypadkach PDA może zamknąć się samoistnie:2325

  • U wcześniaków prawdopodobieństwo samoistnego zamknięcia PDA wynosi 72-75%23
  • U dzieci powyżej 3 miesiąca życia spontaniczne zamknięcie jest rzadkie23
  • Małe PDA mogą zamknąć się samoistnie w miarę wzrostu dziecka26

Konsekwencje nieleczonego PDA

Nieleczony duży PDA może prowadzić do poważnych powikłań:811

Powikłanie Opis Objawy
Nadciśnienie płucne Zwiększony przepływ krwi przez płuca powoduje wzrost ciśnienia w naczyniach płucnych Postępująca duszność, sinica, obrzęki
Niewydolność serca Przeciążenie objętościowe lewej komory prowadzące do jej powiększenia i osłabienia Przyspieszony oddech, męczliwość, słaby przyrost masy ciała
Zespół Eisenmengera Nieodwracalne nadciśnienie płucne prowadzące do odwrócenia kierunku przecieku Sinica, palce pałeczkowate, niewydolność prawokomorowa
Infekcyjne zapalenie wsierdzia Zwiększone ryzyko infekcji wsierdzia Gorączka, ogólne złe samopoczucie, nowe szmery serca
Uszkodzenie płuc Długotrwałe przewodnienie naczyń płucnych Przewlekła choroba płuc, nawracające infekcje

Jak pokazują badania, nieleczony duży PDA wiąże się ze znaczną śmiertelnością. Szacuje się, że śmiertelność wynosi 20% do 20 roku życia, 42% do 45 roku życia i 60% do 60 roku życia.23

Progresja u wcześniaków

Przetrwały przewód tętniczy u wcześniaków stanowi szczególne wyzwanie kliniczne:514

Różnice między małymi a dużymi PDA

Wpływ PDA na organizm dziecka zależy przede wszystkim od wielkości utrzymującego się przewodu:328

  • Małe PDA:
    • Zazwyczaj bezobjawowe
    • Wykrywane często przypadkowo podczas badania fizykalnego (szmer serca)
    • Niewielki wpływ na hemodynamikę
    • Ryzyko infekcyjnego zapalenia wsierdzia
  • Duże PDA:
    • Znaczące objawy kliniczne
    • Zwiększony przepływ krwi przez płuca
    • Przeciążenie objętościowe lewej komory
    • Ryzyko rozwoju nadciśnienia płucnego
    • Możliwość rozwoju zespołu Eisenmengera z odwróceniem kierunku przecieku

Objawy alarmowe i powikłania

Pewne objawy powinny szczególnie zaniepokoić rodziców i skłonić do natychmiastowej konsultacji z lekarzem:118

  • Sinica (niebieskawe zabarwienie skóry) wynikająca z niedotlenienia8
  • Znaczna duszność podczas karmienia lub płaczu1
  • Trudności w karmieniu z towarzyszącym poceniem się1
  • Brak przyrostu masy ciała lub utrata wagi1
  • Stałe przyspieszenie oddechu lub duszność1
  • Nagłe pogorszenie stanu ogólnego8

Długoterminowe powikłania nieleczonego dużego PDA mogą obejmować:298

  • Nadciśnienie płucne – zwiększone ciśnienie w tętnicach płucnych prowadzące do uszkodzenia naczyń płucnych4
  • Zespół Eisenmengera – zaawansowane stadium nadciśnienia płucnego z odwróceniem kierunku przepływu krwi przez PDA29
  • Niewydolność serca – osłabienie mięśnia sercowego w wyniku przewlekłego przeciążenia29
  • Infekcyjne zapalenie wsierdzia – poważna infekcja wewnętrznej wyściółki serca29
  • Przewlekłe uszkodzenie płuc – wtórne do długotrwałego przeciążenia krążenia płucnego11

Rokowanie i przebieg naturalny

Rokowanie u pacjentów z PDA zależy od wielu czynników, w tym wielkości przewodu, wieku pacjenta w momencie diagnozy oraz obecności schorzeń współistniejących.1325

Rokowanie po leczeniu

Większość dzieci po odpowiednim leczeniu PDA ma bardzo dobre rokowanie:230

  • U dzieci urodzonych o czasie z wczesnym rozpoznaniem i leczeniem PDA, aktywność, apetyt i wzrost powinny powrócić do normy18
  • Większość dzieci z zamkniętym PDA prowadzi normalne, zdrowe życie31
  • Długoterminowe problemy są rzadkie, a w większości przypadków nie jest konieczne dalsze leczenie30

U wcześniaków rokowanie może być zróżnicowane w zależności od wieku ciążowego i innych stanów towarzyszących.32

Konsekwencje późno rozpoznanego PDA

U dzieci z dużym PDA rozpoznanym bardzo późno lub nigdy nie leczonym rokowanie jest niepewne:833

  • Zwiększone ryzyko nadciśnienia płucnego8
  • Możliwość rozwoju zespołu Eisenmengera22
  • Przedwczesna śmierć w przypadku dużego, nieleczonego PDA23

Badania pokazują, że nieleczony PDA wiąże się ze znaczną śmiertelnością: 20% do 20 roku życia, 42% do 45 roku życia i 60% do 60 roku życia.23

Monitorowanie i długoterminowa opieka

Nawet po leczeniu, niektórzy pacjenci z PDA wymagają regularnej kontroli:2434

  • Regularne badania kontrolne są konieczne, aby upewnić się, że PDA został prawidłowo zamknięty i nie występują powikłania34
  • Niektórzy pacjenci mogą wymagać dożywotniej opieki kardiologicznej24
  • Szczególnie istotne jest monitorowanie pacjentów po zabiegach przezskórnego zamknięcia lub operacjach34

Wczesne rozpoznanie i leczenie są kluczowe dla skutecznego zarządzania PDA i zapobiegania powikłaniom. Jeśli podejrzewa się, że dziecko może mieć PDA, należy niezwłocznie skonsultować się z lekarzem.34

Rozpoznanie przetrwałego przewodu tętniczego

Diagnoza przetrwałego przewodu tętniczego opiera się na wywiadzie, badaniu fizykalnym oraz badaniach dodatkowych.2435

Badanie fizykalne

Kluczowe elementy badania fizykalnego, które mogą sugerować PDA:1314

  • Szmer serca – klasyczny szmer PDA to szmer ciągły, „maszynowy”, najgłośniejszy pod obojczykiem, promieniujący do pleców13
  • Tętno skaczące (tzw. tętno Corrigana) – silne, wzmożone tętno obwodowe13
  • Wzmożone uderzenie koniuszkowe – wynik zwiększonego obciążenia serca13
  • Tachykardia – przyspieszony rytm serca13

U wcześniaków klasyczne objawy mogą być nieobecne, a diagnostyka PDA może być trudniejsza.14

Badania diagnostyczne

W przypadku podejrzenia PDA wykonuje się następujące badania:3024

  • Badanie RTG klatki piersiowej – może wykazać powiększenie serca i nieprawidłowy przepływ krwi do płuc30
  • Echokardiografia – badanie z wyboru potwierdzające diagnozę PDA; umożliwia ocenę wielkości przewodu, kierunku przepływu krwi oraz funkcji serca30
  • Elektrokardiografia (EKG) – może wykazać cechy przeciążenia lewej komory w przypadku dużego PDA35

W niektórych przypadkach rozpoznanie PDA może być opóźnione, szczególnie jeśli przewód jest mały i nie powoduje wyraźnych objawów klinicznych.24

Kolejne rozdziały

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  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Patent ductus arteriosus (PDA) | Beacon Health System
    https://www.beaconhealthsystem.org/library/diseases-and-conditions/patent-ductus-arteriosus-pda?content_id=CON-20376123
    Patent ductus arteriosus symptoms (PDA) depend on the size of the opening and the person’s age. A small PDA might not cause symptoms. Some people don’t notice symptoms until adulthood. A large PDA can cause symptoms of heart failure soon after birth. […] A large PDA found during infancy or childhood might cause: Poor eating, which leads to poor growth. Sweating with crying or eating. Constant fast breathing or being out of breath. Easy tiring. Rapid heart rate. […] Contact a healthcare professional if your baby or older child: Tires easily when eating or playing. Isn’t gaining weight. Becomes breathless when eating or crying. Always breathes fast or is short of breath.
  • #2 Patent Ductus Arteriosus (PDA): Symptoms and Treatment
    https://my.clevelandclinic.org/health/diseases/17325-patent-ductus-arteriosus-pda
    Patent ductus arteriosus (PDA) causes problems with blood flow between the heart and lungs. […] A moderate or large PDA can cause babies to breathe faster and harder than normal, as their bodies try to keep up with the extra blood in their lung arteries. If left untreated for a prolonged period, a PDA can lead to the development of pulmonary hypertension (high blood pressure in the lungs) and blood vessel damage. […] PDA symptoms vary according to patent ductus arteriosus types. Small PDAs may not cause any symptoms other than a heart murmur. […] Larger PDAs may cause rapid breathing, shortness of breath (dyspnea), sweating during feedings, fatigue or tiredness, feeding and eating problems, poor weight gain or growth, and fast pulse or heart rate. […] With treatment, most babies born with PDA live healthy and active lives. […] If PDA doesn’t close on its own, healthcare providers can correct it, if needed. Babies and children with moderate and large sized PDAs that are not treated in the correct timeframe may be at higher risk for developing heart complications as adults.
  • #3 Patent Ductus Arteriosus Symptoms and Causes
    https://www.structuralheart.abbott/patients/congenital-heart-disease/patent-ductus-arteriosus
    Severity of patent ductus arteriosus symptoms often depends on the size of the PDA. Small PDAs may cause no symptoms and are sometimes only detected by the doctor hearing a heart murmur through a stethoscope. Medium to large PDAs may cause fatigue, poor growth and eventually lead to heart failure. All sizes of PDAs may increase a patient’s risk for a bacterial infection. Symptoms of patent ductus arteriosus may include: […] Heart Murmur […] Difficulty in breathing […] Shortness of Breath […] Poor weight gain […] Sweating or crying while eating […] A significant PDA can cause the heart to overwork, can inhibit patient growth, and become life-threatening.
  • #4 Patent Ductus Arteriosus (PDA) | American Heart Association
    https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/patent-ductus-arteriosus-pda
    If the PDA is small, it won’t cause symptoms because the heart and lungs don’t have to work harder. The only abnormal finding may be a distinctive type of murmur (noise heard with a stethoscope). […] If the PDA is large, the child may breathe faster and harder than normal. Infants may have trouble feeding and growing at a normal rate. Symptoms may not occur until several weeks after birth. High pressure may occur in the blood vessels in the lungs because more blood than normal is being pumped there. Over time this may cause permanent damage to the lung blood vessels. […] If the PDA is small, it won’t cause symptoms or problems because the blood flow and pressure in the heart and lungs aren’t changed appreciably from normal. The only abnormal finding may be a distinctive type of murmur (noise heard with a stethoscope), sometimes called a „machinery” murmur.
  • #4 Patent Ductus Arteriosus (PDA) | American Heart Association
    https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/patent-ductus-arteriosus-pda
    If the PDA is large, breathlessness may be due to reduced heart function or problems related to high pressures in the lungs. High pressure may occur in the lung vessels because more blood than normal is being pumped there. Over time this may cause permanent damage to the lung blood vessels (pulmonary hypertension).
  • #5 Patent Ductus Arteriosus (PDA) – Pediatrics – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/patent-ductus-arteriosus-pda
    Patent ductus arteriosus (PDA) is a persistence of the fetal connection (ductus arteriosus) between the aorta and pulmonary artery after birth. 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. […] Infants and children with a small PDA are generally asymptomatic; infants with a large PDA present with signs of heart failure (eg, failure to thrive, poor feeding, tachypnea, dyspnea with feeding, tachycardia). Preterm infants may present with respiratory distress, apnea, worsening mechanical ventilation requirements, or other serious complications (eg, necrotizing enterocolitis). Signs of heart failure occur earlier in preterm infants than in full-term infants and may be more severe.
  • #5 Patent Ductus Arteriosus (PDA) – Pediatrics – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/patent-ductus-arteriosus-pda
    A large ductal shunt in a preterm infant often is a major contributor to the severity of the lung disease of prematurity. […] Over time, a large shunt causes left heart enlargement, pulmonary artery hypertension, and elevated pulmonary vascular resistance, ultimately leading to Eisenmenger syndrome if untreated.
  • #6 Patent Ductus Arteriosus (PDA) (for Parents) | Nemours KidsHealth
    https://kidshealth.org/en/parents/patent-ductus-arteriosus.html
    Patent ductus arteriosus (PDA) is an extra blood vessel found in babies before birth and just after birth. […] If it stays open longer, it may cause extra blood to flow to the lungs. Problems are most likely if the PDA is large. […] If the ductus doesn’t close, the result is a patent (meaning „open”) ductus arteriosus. The PDA lets oxygen-rich blood (blood high in oxygen) from the aorta mix with oxygen-poor blood (blood low in oxygen) in the pulmonary artery. As a result, too much blood flows into the lungs, which puts a strain on the heart and increases blood pressure in the pulmonary arteries. […] Babies with a large PDA might have symptoms such as: a bounding (strong and forceful) pulse, fast breathing, not feeding well, shortness of breath, sweating while feeding, tiring very easily, poor growth.
  • #7 Patent Ductus Arteriosus (PDA) | Children’s Hospital of Philadelphia
    https://www.chop.edu/conditions-diseases/patent-ductus-arteriosus-pda
    Symptoms vary depending on the size of the PDA. Children with a tiny or small PDA usually have no symptoms. Symptoms in children with a larger PDA may include: […] Breathing difficulties soon after birth (especially in premature babies) […] Heart murmur, or an abnormal sound heard through a stethoscope, which is the blood flowing through the ductus arteriosus […] Rapid breathing […] Difficulty feeding and poor growth […] A strong pulse, (sometimes called a bounding pulse) […] Lung infections (pneumonia).
  • #8 Patent Ductus Arteriosus (PDA) | Cedars-Sinai
    https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/p/patent-ductus-arteriosus-pda.html
    Patent ductus arteriosus (PDA) is a heart defect found in the days or weeks after birth. […] If it stays open (patent), it’s called patent ductus arteriosus. With PDA, extra blood flows to the lungs. If the PDA is large, too much blood goes to the lungs. The blood vessels and the lungs have to work much harder to handle the extra blood. This can lead to fluid buildup in the lungs. The baby can have a harder time breathing and feeding. […] The size of the opening between the aorta and the pulmonary artery will affect symptoms. If your baby has a small opening, they may not have symptoms. If your baby has a larger opening, they may have symptoms. These are the most common symptoms of PDA: Skin that turns a blue color from not getting enough oxygen (cyanosis), Very tired, Fast or hard breathing, Trouble feeding, or tiredness while feeding, Infections, Poor weight gain, In older children, trouble doing activities.
  • #8 Patent Ductus Arteriosus (PDA) | Cedars-Sinai
    https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/p/patent-ductus-arteriosus-pda.html
    If not treated, PDA may lead to long-term lung damage. It can also damage the blood vessels in the lungs. […] In children with large PDAs diagnosed very late or never repaired, the outlook is uncertain. They are at risk for increased blood pressure in the blood vessels of the lungs (pulmonary hypertension).
  • #9 Patent Ductus Arteriosus – Children’s Hospital of Orange County
    https://choc.org/heart/congenital-heart-defects/patent-ductus-arteriosus/
    Symptoms may include: Fatigue, Sweating, Rapid breathing, Heavy breathing, Congested breathing, Disinterest in feeding, or tiring while feeding, Poor weight gain. […] The symptoms of a PDA may resemble other medical conditions or heart problems and should be discussed with the child’s doctor. […] Premature babies with a PDA may have difficulty breathing because of this extra blood flow to the lungs at high pressure. They may remain on the ventilator for a longer period of time. The support from the ventilator also may be high, due to this extra blood flow to the lungs. Older infants or children with a PDA may breathe faster than normal or tire easily, but many children do not have obvious problems. […] Untreated PDA may lead to long-term lung damage; however, this is uncommon, because most children are treated for their PDA before the lungs get damaged.
  • #10 Patent Ductus Arteriosus (PDA) – Conditions and Treatments | Children’s National Hospital
    https://www.childrensnational.org/get-care/health-library/patent-ductus-arteriosus-pda
    PDA is a heart problem that is frequently noted in the first few weeks or months after birth. […] Symptoms may include: Fatigue, Sweating, Rapid breathing, Heavy breathing, Congested breathing, Disinterest in feeding, or tiring while feeding, Poor weight gain. […] The size of the connection between the aorta and the pulmonary artery will affect the type of symptoms noted, the severity of symptoms, and the age at which they first occur. The larger the opening, the greater the amount of blood that passes through that overloads the lungs. […] A child with a small patent ductus arteriosus might not have any symptoms, and your child’s doctor may have only noted the defect by hearing a heart murmur. Other infants with a larger patent ductus arteriosus may exhibit different symptoms. […] The symptoms of a patent ductus arteriosus may resemble other medical conditions or heart problems. Always consult your child’s doctor for a diagnosis.
  • #11 Patent Ductus Arteriosus (PDA) – Stanford Medicine Children’s Health
    https://www.stanfordchildrens.org/en/topic/default?id=patent-ductus-arteriosus-pda-90-P01811
    Patent ductus arteriosus (PDA) is a heart defect found in the days or weeks after birth. […] If it stays open (patent), it is called patent ductus arteriosus. With PDA, extra blood flows to the lungs. If the PDA is large, too much blood goes to the lungs. The blood vessels and the lungs have to work much harder to handle the extra blood. This can lead to fluid buildup in the lungs. The baby can have a harder time breathing and feeding. […] The size of the opening between the aorta and the pulmonary artery will affect symptoms. If your baby has a small opening, he or she may not have symptoms. If your baby has a larger opening, he or she may have symptoms. These are the most common symptoms of PDA: Skin turns a blue color from not getting enough oxygen (cyanosis), Very tired, Fast or hard breathing, Trouble feeding, or tiredness while feeding, Infections, Poor weight gain, In older children, trouble doing activities.
  • #11 Patent Ductus Arteriosus (PDA) – Stanford Medicine Children’s Health
    https://www.stanfordchildrens.org/en/topic/default?id=patent-ductus-arteriosus-pda-90-P01811
    The symptoms of PDA can seem like other health conditions. Have your child see his or her healthcare provider for a diagnosis. […] If a PDA does not close, it will be fixed to prevent lung problems. Treatment may include the following. […] Surgery can close PDAs. Surgical closure is often advised for babies younger than 6 months who have large defects and symptoms such as poor weight gain and fast breathing. […] If not treated, PDA may lead to long-term lung damage. It can also damage the blood vessels in the lungs. […] In children with large PDAs diagnosed very late or never repaired, the outlook is uncertain. They are at risk for increased blood pressure in the blood vessels of the lungs (pulmonary hypertension).
  • #12 Patent Ductus Arteriosus (PDA) | Symptoms, Diagnosis & Treatment
    https://www.cincinnatichildrens.org/health/p/patent-ductus-arteriosus
    The symptoms of a patent ductus arteriosus depend on the size of the ductus and how much blood flow it carries. […] A newborn with a patent ductus arteriosus may have: Fast breathing, A hard time breathing, More respiratory infections, A tendency to tire more easily, Poor growth. […] Even if there are no symptoms, the turbulent flow of blood through the patent ductus arteriosus puts a person at a higher risk for a serious infection, known as endocarditis.
  • #13 Patent Ductus Arteriosus – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK430758/
    The ductus arteriosus is a fetal vessel that allows the oxygenated blood from the placenta to bypass the lungs in utero. […] In premature infants, the ductus arteriosus does not close rapidly and may require pharmacologic or surgical closure to treat side effects. […] The classic PDA murmur is a continuous, machinery murmur below the clavicle, radiating to the back, although it can also manifest as a systolic or holosystolic murmur. The infant will have a prominent precordial impulse, tachycardia, and bounding peripheral pulses due to increased cardiac output. […] A patent ductus arteriosus (PDA) is rare in healthy term newborns. As gestational age decreases, the incidence of PDA increases. […] If the PDA is hemodynamically significant despite pharmacologic therapy and results in increased respiratory support or renal impairment, or if there are contraindications to the use of pharmacologic therapy, surgical ligation can be performed.
  • #13 Patent Ductus Arteriosus – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK430758/
    The prognosis is dependent on other comorbidities. After the closure of the PDA, most children have a normal life expectancy. […] The morbidity and mortality are linked to the volume of blood flow via the PDA. If left untreated, pulmonary hypertension can develop, which will lead to premature death.
  • #14 Patent Ductus Arteriosus: Symptoms and Treatment | Doctor
    https://patient.info/doctor/patent-ductus-arteriosus
    Physical examination commonly reveals bounding peripheral pulses, a hyperactive precordium, and tachycardia with or without gallop rhythm. […] PDA is commonly diagnosed in extremely preterm infants and is associated with numerous pathologies, including chronic lung disease (CLD), NEC and intraventricular haemorrhage (IVH).
  • #14 Patent Ductus Arteriosus: Symptoms and Treatment | Doctor
    https://patient.info/doctor/patent-ductus-arteriosus
    Patent ductus arteriosus (PDA) occurs in 5-10% of all congenital heart defects, excluding premature infants. PDAs are very common in preterm babies and can have significant physiological effects. […] A large-shunt PDA may cause lower respiratory tract infection as well as feeding difficulties and poor growth during infancy, with failure to thrive because of heart failure. […] If the pulmonary circulation is markedly overloaded there will be tachycardia, tachypnoea and a wide pulse pressure. […] Patients with a small PDA are usually asymptomatic. […] In a preterm infant, PDA should be suspected if the respiratory distress because of hyaline membrane disease does not improve or worsens after initial improvement and the baby cannot be weaned off the ventilator. […] In the premature infant of low birth weight, the classical signs are usually absent. The continuous murmur is rarely heard.
  • #15 Patent Ductus Arteriosus (PDA)
    https://healthlibrary.avera.org/Library/DiseasesConditions/Pediatric/Cardiology/90,P01811
    Patent ductus arteriosus (PDA) is a heart defect found in the days or weeks after birth. If it stays open (patent), it’s called patent ductus arteriosus. With PDA, extra blood flows to the lungs. If the PDA is large, too much blood goes to the lungs. The blood vessels and the lungs have to work much harder to handle the extra blood. This can lead to fluid buildup in the lungs. The baby can have a harder time breathing and feeding. […] The size of the opening between the aorta and the pulmonary artery will affect symptoms. If your baby has a small opening, they may not have symptoms. If your baby has a larger opening, they may have symptoms. These are the most common symptoms of PDA: Skin that turns a blue color from not getting enough oxygen (cyanosis), Tiredness, Fast or hard breathing, Trouble feeding, tiredness while feeding, or sweating during feeding, Infections, Poor weight gain, Frequent respiratory infections, In older children, trouble doing activities. […] The symptoms of PDA can seem like other health conditions. Have your child see their health care provider for a diagnosis.
  • #16 When Your Child Has a Patent Ductus Arteriosus (PDA) | Saint Luke’s Health System
    https://www.saintlukeskc.org/health-library/when-your-child-has-patent-ductus-arteriosus-pda
    Most children with a small PDA have no symptoms. Children with a large PDA are more likely to have symptoms. These can include: […] Trouble breathing or rapid breathing […] Trouble feeding […] Slow weight gain […] Frequent respiratory infections […] Heart murmur. A PDA can lead to heart and lung function that gets worse over time. In severe cases, the increased blood flow to the lungs and overwork of the left ventricle can lead to congestive heart failure (CHF).
  • #17 Patent Ductus Arteriosus (PDA) Clinical Presentation: History, Physical Examination
    https://emedicine.medscape.com/article/891096-clinical
    Patients can present at any age. The typical child with a patent ductus arteriosus (PDA) is asymptomatic. At times, the patient may report decreased exercise tolerance or pulmonary congestion in conjunction with a murmur. […] Three-week to 6-week-old infants can present with tachypnea, diaphoresis, inability or difficulty with feeding, and weight loss or no weight gain. […] A ductus arteriosus with a moderate-to-large left-to-right shunt may be associated with a hoarse cry, cough, lower respiratory tract infections, atelectasis, or pneumonia. With large defects, the patient may have a history of feeding difficulties and poor growth during infancy, described as failure to thrive (FTT). However, frank symptoms of congestive heart failure (CHF) are rare. […] Adults whose patent ductus arteriosus (PDA) has gone undiagnosed may present with signs and symptoms of heart failure, atrial arrhythmia, or even differential cyanosis limited to the lower extremities, indicating shunting of unoxygenated blood from the pulmonary to systemic circulation.
  • #18 Patent Ductus Arteriosus (PDA) | University Hospitals
    https://www.uhhospitals.org/health-information/health-and-wellness-library/article/diseases-and-conditions—pediatrics/patent-ductus-arteriosus-pda
    Patent ductus arteriosus (PDA) is a heart defect found in the days or weeks after birth. […] If it stays open (patent), it’s called patent ductus arteriosus. With PDA, extra blood flows to the lungs. If the PDA is large, too much blood goes to the lungs. The blood vessels and the lungs have to work much harder to handle the extra blood. This can lead to fluid buildup in the lungs. The baby can have a harder time breathing and feeding. […] The size of the opening between the aorta and the pulmonary artery will affect symptoms. If your baby has a small opening, they may not have symptoms. If your baby has a larger opening, they may have symptoms. These are the most common symptoms of PDA: Skin that turns a blue color from not getting enough oxygen (cyanosis), Tiredness, Fast or hard breathing, Trouble feeding, tiredness while feeding, or sweating during feeding, Infections, Poor weight gain, Frequent respiratory infections, In older children, trouble doing activities.
  • #18 Patent Ductus Arteriosus (PDA) | University Hospitals
    https://www.uhhospitals.org/health-information/health-and-wellness-library/article/diseases-and-conditions—pediatrics/patent-ductus-arteriosus-pda
    The symptoms of PDA can seem like other health conditions. Have your child see their health care provider for a diagnosis. […] If a PDA does not close, it will be fixed to prevent lung problems. […] A PDA that causes symptoms will need to be treated with medicine, cardiac catheterization, or surgery. […] Surgery can close PDAs. Surgical closure is often advised for babies younger than 6 months who have large defects and symptoms, such as poor weight gain and fast breathing. […] If not treated, PDA may lead to long-term lung damage. […] In children born full-term, early diagnosis and repair of PDA lets them live normal, healthy lives. Activity levels, appetite, and growth should return to normal. […] In children with large PDAs diagnosed very late or never repaired, the outlook is uncertain. They are at risk for increased blood pressure in the blood vessels of the lungs (pulmonary hypertension).
  • #19 Patent ductus arteriosus (PDA) – BHF
    https://www.bhf.org.uk/informationsupport/conditions/patent-ductus-arteriosus-pda
    Larger PDAs cause more symptoms. If you have a small PDA then you may have no symptoms except for a heart murmur. […] Other signs and symptoms include: […] Babies and children: not feeding or eating well, sweating while feeding or eating, not gaining weight. […] Adults: feeling very tired (fatigue), irregular or extra heart beats, fast breathing or shortness of breath, especially when exercising. […] If you have any of these symptoms or your symptoms are getting worse, speak to your doctor. Symptoms can be a sign that your heart is working harder than normal, and you may need treatment.
  • #20 Patent Ductus Arteriosus Symptoms and Treatment | Baptist Health
    https://www.baptisthealth.com/care-services/conditions-treatments/patent-ductus-arteriosus
    A small PDA may close on its own over the first few months of a childs life and have no symptoms, aside from a PAD heart murmur that will only be detected with a stethoscope. […] A large PDA heart condition may cause an infant to breathe harder and have difficulty feeding and growing. […] Patent ductus arteriosus symptoms will vary depending on the size of the PDA heart condition a small PDA may have no symptoms at all. Below is a list of patent ductus arteriosus signs and symptoms: Rapid heart rate, Tiring easily, Poor eating, and consequently, poor growth, Sweating when crying or eating, Chronic rapid breathing or breathlessness. […] In adults, an undetected PDA would show symptoms such as shortness of breath and heart palpitations.
  • #21 Patent Ductus Arteriosus (PDA) – Symptoms and Risk Factors | Dr Raghu
    https://drraghu.com/resources/congenital-heart-disease/patent-ductus-arteriosus/
    Patent ductus arteriosus (PDA) is a congenital heart condition in which there is an opening between the pulmonary artery and the aorta. […] The symptoms depend on the size of the patent duct and the gestational age of the neonate. A small patent ductus arteriosus can remain unrecognized until adulthood, whereas, a large patent ductus arteriosus may lead to life threatening conditions such as heart failure. […] In infants, a large PDA would show the following symptoms: Inability or difficulty in feeding, leading to poor growth, Sweating on crying or eating, Persistent fast breathing or breathlessness, Cough, Lower respiratory tract infections, Pneumonia, Easy tiring, Rapid heart rate. […] The symptoms in the case of adults with undiagnosed PDA include heart failure, fast heart beating (atrial fibrillation) or with the reversal of shunting – unoxygenated blood from the right side of heart to the left side of heart.
  • #22 Patent ductus arteriosus – Wikipedia
    https://en.wikipedia.org/wiki/Patent_ductus_arteriosus
    Symptoms are uncommon at birth and shortly thereafter, but later in the first year of life there is often the onset of an increased work of breathing and failure to gain weight at a normal rate. […] With time, an uncorrected PDA usually leads to pulmonary hypertension followed by right-sided heart failure. […] Common symptoms include: dyspnea (shortness of breath). […] Signs include: tachycardia (a heart rate exceeding the normal resting rate), continuous „machine-like” heart murmur, cardiomegaly (enlarged heart), left subclavicular thrill, bounding pulse, widened pulse pressure, increased cardiac output, increased systolic pressure, poor growth, differential cyanosis. […] If left untreated, the disease may progress from left-to-right shunt (acyanotic heart) to right-to-left shunt (cyanotic heart), called Eisenmenger’s syndrome. Pulmonary hypertension is a potential long-term outcome, which may require a heart and/or lung transplant.
  • #23 Patent Ductus Arteriosus (PDA): Background, Anatomy, Pathophysiology
    https://emedicine.medscape.com/article/891096-overview
    Spontaneous closure in those older than 3 months is rare. In those younger than 3 months, spontaneous closure in premature infants is 72-75%. […] Morbidity and mortality rates are directly related to the flow volume through the ductus arteriosus. A large PDA may cause congestive heart failure (CHF); if left untreated for a long period, pulmonary hypertension may develop. […] As many as 20% of neonates with respiratory distress syndrome have PDA. In babies who are less than 1500 g at birth, many studies show the incidence of a PDA to exceed 30%. […] It is estimated that left untreated, the mortality rate for PDA is 20% by age 20 years, 42% by age 45 years, and 60% mortality rate by age 60 years.
  • #24 Patent ductus arteriosus (PDA) – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/patent-ductus-arteriosus/diagnosis-treatment/drc-20376150
    To diagnose patent ductus arteriosus (PDA), a healthcare professional does a physical exam and asks questions about you or your child’s medical history. The healthcare professional may hear a heart sound called a murmur while listening to the heart with a stethoscope. […] Some people with small PDAs may only need regular health checkups to watch for complications. A premature baby born with patent ductus arteriosus also needs regular checkups to make sure the opening closes. […] A premature baby born with patent ductus arteriosus (PDA) may get medicines called nonsteroidal anti-inflammatory drugs. These medicines, also called NSAIDs, block certain body chemicals that keep the PDA open. However, these medicines won’t close a PDA in full-term babies, children or adults. […] Some people born with PDA need regular health checkups for life, even after treatment to close the opening. During these checkups, a healthcare professional may do tests to check for complications. […] A large patent ductus arteriosus or one that’s causing serious health concerns may be diagnosed immediately at birth. But some smaller ones might not be found until later in life.
  • #25 Patent Ductus Arteriosus: Causes, Symptoms & Treatment | Banner
    https://www.bannerhealth.com/services/heart/heart-disease/congenital-heart-defects/types/patent-ductus-arteriosus
    Patent ductus arteriosus (PDA) is a congenital heart defect (CHD). This means it is a problem with the hearts structure that is present at birth. PDA causes problems with blood flow between the heart and lungs. […] Many children with PDA have no symptoms, especially if the hole is small. […] However, if the PDA is large, it can cause: Heart murmur: A swooshing noise heard with a stethoscope, Tiring very easily, Rapid or heavy breathing, especially during feeding, Sweating while feeding or crying, Slow growth and weight gain, Frequent lung infections, like pneumonia. […] Over time, this condition can weaken the heart and lead to pulmonary hypertension (high blood pressure in the lungs). […] A small PDA may not cause problems. Large untreated PDAs could lead to long-term lung and heart damage, including pulmonary hypertension and heart failure. A child with untreated PDA is also at greater risk for endocarditis, an infection of the inner lining of the heart or heart valves.
  • #26 Patent Ductus Arteriosus (PDA)
    https://healthlibrary.brighamandwomens.org/conditions/Heart/90,P01811
    Patent ductus arteriosus (PDA) is a heart defect found in the days or weeks after birth. The size of the opening between the aorta and the pulmonary artery will affect symptoms. If your baby has a small opening, they may not have symptoms. If your baby has a larger opening, they may have symptoms. These are the most common symptoms of PDA: Skin that turns a blue color from not getting enough oxygen (cyanosis), Tiredness, Fast or hard breathing, Trouble feeding, tiredness while feeding, or sweating during feeding, Infections, Poor weight gain, Frequent respiratory infections, In older children, trouble doing activities. The symptoms of PDA can seem like other health conditions. Have your child see their health care provider for a diagnosis. […] If not treated, PDA may lead to long-term lung damage. It can also damage the blood vessels in the lungs. But this is not common because most children will have been treated for their PDA before the lungs and blood vessels get damaged. […] A small PDA may close on its own as your child grows. If it is large or does not close, your child will need a repair procedure. Most children with a fixed PDA will live normal, healthy lives.
  • #27 Patent Ductus Arteriosus | UCSF Department of Surgery
    https://pedctsurgery.ucsf.edu/condition/patent-ductus-arteriosus
    Premature infants who have PDA are more likely to have damage to their lungs from the extra blood flowing through the PDA. These infants may need to be on ventilators to help them breathe. […] Some infants may develop signs or symptoms of volume overload on the heart and excess blood flow in the lungs. Signs and symptoms may include: Fast breathing, working hard to breathe, or shortness of breath. Premature infants may need increased oxygen or help breathing from a ventilator. Poor feeding and poor weight gain. Tiring easily. Sweating with exertion, such as while feeding.
  • #28 Patent Ductus Arteriosus – Pediatric Heart Specialists
    https://pediatricheartspecialists.com/heart-education/15-congenital-heart-defects/172-patent-ductus-arteriosus
    Symptoms from a PDA are related to excess blood flow to the lungs. They are usually seen in patients with large PDA’s, but may be absent in the setting of moderate size defects as well. Small PDA’s rarely if ever produce symptoms. In patients who develop symptoms, the most common finding is a rapid respiratory rate. This may be more obvious during times of exertion, such as feeding in an infant. Other symptoms in infants include sweating with exertion, poor feeding due to fatigue, and poor weight gain. PDAs may also predispose to an increased risk of lung infections such as pneumonia. […] The amount is primarily determined by the size of the PDA. A large PDA can allow for a significant increase in blood flow into the lungs; a small PDA often results in a negligible increase.
  • #29 Patent ductus arteriosus (PDA) // Middlesex Health
    https://middlesexhealth.org/learning-center/diseases-and-conditions/patent-ductus-arteriosus-pda
    Patent ductus arteriosus symptoms (PDA) depend on the size of the opening and the person’s age. A small PDA might not cause symptoms. Some people don’t notice symptoms until adulthood. A large PDA can cause symptoms of heart failure soon after birth. […] A large PDA found during infancy or childhood might cause: Poor eating, which leads to poor growth. Sweating with crying or eating. Constant fast breathing or being out of breath. Easy tiring. Rapid heart rate. […] A small patent ductus arteriosus might not cause complications. Larger, untreated PDAs could cause: High blood pressure in the lungs, also called pulmonary hypertension. A large PDA causes irregular blood flow in the heart and lungs. As a result, pressure goes up in the pulmonary artery. Over time, the increased pressure damages the smaller blood vessels in the lungs. A life-threatening and lasting type of lung damage called Eisenmenger syndrome may occur. Heart failure. Symptoms of this serious complication include rapid breathing, often with gasping breaths, and poor weight gain. Heart infection, called endocarditis. Patent ductus arteriosus can increase the risk of germs attaching to areas in the heart. Without quick treatment, endocarditis can damage or destroy the heart valves.
  • #30 Patent Ductus Arteriosus (PDA) > Fact Sheets > Yale Medicine
    https://www.yalemedicine.org/conditions/patent-ductus-arteriosus
    If medication isnt effective or a babys health is endangered, catheterization or a surgical procedure may be required to close the PDA. […] The vast majority of children who are treated for PDAs live a normal life. While they should be monitored for complicationsespecially if they have other disorders as welllong-term problems are rare, and in most cases, no follow-up treatment is necessary.
  • #30 Patent Ductus Arteriosus (PDA) > Fact Sheets > Yale Medicine
    https://www.yalemedicine.org/conditions/patent-ductus-arteriosus
    Symptoms include heart murmur, a strangely strong pulse, and rapid breathing […] Babies who have a PDA may have some combination of the following symptoms: Heart murmur, Especially strong pulse, Rapid breathing, Failure to thrive, Poor feeding, Poor growth, Sweating during feeding, Shortness of breath, Fatigue, Increase in heart rate. […] Larger PDAs can cause extra blood to flow into the lungs, which can increase pressure in the lung arteries, putting a strain on the heart, and even cause heart failure. […] If a doctor suspects an infants symptoms may be caused by a PDA, an investigative X-ray may be done to see whether the heart is enlarged and to look for abnormal blood flow to the lungs. An echocardiogram (an ultrasound of the heart) confirms the diagnosis of PDA. […] In many cases a PDA will resolve on its own in the first few months or at least within the first year of life.
  • #31 Patent Ductus Arteriosus (PDA)
    https://healthlibrary.osfhealthcare.org/Search/90,P01811
    Patent ductus arteriosus (PDA) is a heart defect found in the days or weeks after birth. […] If it stays open (patent), it’s called patent ductus arteriosus. With PDA, extra blood flows to the lungs. If the PDA is large, too much blood goes to the lungs. The blood vessels and the lungs have to work much harder to handle the extra blood. This can lead to fluid buildup in the lungs. The baby can have a harder time breathing and feeding. […] The size of the opening between the aorta and the pulmonary artery will affect symptoms. If your baby has a small opening, they may not have symptoms. If your baby has a larger opening, they may have symptoms. These are the most common symptoms of PDA: Skin that turns a blue color from not getting enough oxygen (cyanosis), Tiredness, Fast or hard breathing, Trouble feeding, tiredness while feeding, or sweating during feeding, Infections, Poor weight gain, Frequent respiratory infections, In older children, trouble doing activities. […] If not treated, PDA may lead to long-term lung damage. It can also damage the blood vessels in the lungs. […] Most children with a fixed PDA will live normal, healthy lives.
  • #32 Partners in Care | Patent Ductus Arteriosus treatment at the Texas…
    https://partnersincare.health/conditions/patent-ductus-arteriosus
    A small PDA may not cause any symptoms and could go undetected. […] Symptoms of a large PDA may include: Fatigue, Frequent respiratory infections, Heart murmur, Heavy, rapid, or congested breathing, Poor weight gain, Rapid heart rate, Sweating, Trouble feeding, disinterest in eating, or tiring while feeding. […] If the ductus arteriosus is small, the lungs may be able to accommodate the extra blood and treatment may not be needed. In premature babies, a PDA may close on its own after a longer period of time than expected for a baby born full-term. If your baby has a small PDA or is premature, your pediatric cardiologist may recommend monitoring your baby’s health closely. […] After treatment, a premature baby’s prognosis can vary depending on your child’s gestational age and other conditions. Most full-term babies who had early treatment for a PDA experience healthy growth, appetite, and activity levels. Children who received PDA treatment later in life or have an unresolved PDA may need ongoing care and monitoring.
  • #33 Patent Ductus Arteriosus (PDA)
    https://encyclopedia.nm.org/yourfamily/women/90,P01811
    The symptoms of PDA can seem like other health conditions. Have your child see their health care provider for a diagnosis. […] If not treated, PDA may lead to long-term lung damage. It can also damage the blood vessels in the lungs. But this is not common because most children will have been treated for their PDA before the lungs and blood vessels get damaged. […] In children with large PDAs diagnosed very late or never repaired, the outlook is uncertain. They are at risk for increased blood pressure in the blood vessels of the lungs (pulmonary hypertension).
  • #34 Patent Ductus Arteriosus (PDA): A Comprehensive Guide – Longmore Clinic
    https://longmoreclinic.org/patent-ductus-arteriosus-pda-a-comprehensive-guide/
    Regular check-ups are essential to ensure that the PDA has closed properly and that there are no ongoing issues or complications. If a child had a catheter-based procedure or surgery, follow-up care is particularly important to monitor for any issues related to the procedure. […] Remember, early diagnosis and treatment are essential for managing PDA effectively and preventing complications. If you suspect your child may have PDA, seek medical attention promptly.
  • #35 Patent ductus arteriosus – Symptoms, diagnosis and treatment | BMJ Best Practice
    https://bestpractice.bmj.com/topics/en-gb/766
    Patent ductus arteriosus (PDA) occurs when the ductus arteriosus, a vascular fetal structure that usually closes in the first 48 hours after birth, fails to close. […] Persistence of the ductus arteriosus can result in heart failure, increased pulmonary pressures, and endarteritis. […] Clinical history and presentation can vary significantly depending on age of the child and the size of the ductus. Patients may be entirely asymptomatic or have signs and symptoms of heart failure and haemodynamic instability.