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Patent ductus arteriosus
What are the symptoms of patent ductus arteriosus?
Patients with patent ductus arteriosus may exhibit several clinical manifestations based on the amount of shunting. 1. Small shunt volume: The internal diameter of the patent ductus arteriosus is small, and the patient may exhibit no subjective symptoms. The prominent sign is a continuous machinery murmur heard at the left sternal border at the second intercostal space and below the left clavicle, accompanied by a thrill; pulse pressure may slightly increase. 2. Moderate shunt: Patients commonly experience fatigue, palpitations, shortness of breath, and chest discomfort after exertion. The heart murmur is similar in character to the above but louder, accompanied by a thrill, and widely transmitted. At times, diastolic and mild systolic murmurs caused by left ventricular enlargement, relative mitral valve insufficiency, and stenosis can be heard at the apex, with a positive vascular sign. 3. Large shunt volume: This condition in a patent ductus arteriosus often accompanies secondary severe pulmonary hypertension, leading to a right-to-left shunt. The typical murmur's diastolic component may diminish or disappear, followed by the disappearance of the systolic murmur, and only a diastolic murmur due to pulmonic valve insufficiency can be heard. Patients often exhibit cyanosis and severe clinical symptoms.
Is patent ductus arteriosus related to pregnancy?
The ductus arteriosus is a vital conduit in the fetus during intrauterine life, connecting the blood from the placenta to the pulmonary artery and the aorta, enabling the placental blood to reach the aorta and supply blood to the entire body of the fetus. Usually, if the fetus is viable, there should be no issues, so the non-closure of the ductus arteriosus is not related to the pregnancy period. After the birth of the fetus, as the lungs expand and heart function changes, the ductus arteriosus will automatically begin to close. In the vast majority of infants, the ductus arteriosus will likely close after three months of birth. If it has not completely closed within one year, it is considered that the child has patent ductus arteriosus. Therefore, in most cases, patent ductus arteriosus is not related to the pregnancy period. There might be a small fraction of cases where it could be due to poor development during the pregnancy, preventing the timely closure of the ductus arteriosus; however, in most cases, it is unrelated to the pregnancy period.
Is surgery necessary for an unclosed arterial duct?
Patent ductus arteriosus is a type of congenital heart disease. Currently, surgical treatment is recommended for patients because it involves minimally invasive techniques. Additionally, post-surgery recovery is quick, and there are fewer complications. Particularly for this disease, medication is often not very effective and does not achieve the therapeutic goal. Surgical treatment can completely resolve the patient's issues, thereby reducing the frequency of recurrence and not affecting the child's growth and development. In the meantime, it is still vital to actively prevent respiratory infections.
Does patent ductus arteriosus cause easy sweating?
The arterial duct is prone to sweating. During this period, it is best to advise patients to monitor changes in blood pressure, heart rate, and pulse. Sometimes there may be incidences of rapid heart rate, as this is a type of congenital heart disease. If a patient is prone to respiratory infections, especially pneumonia, this condition can lead to a decrease in resistance. For such patients with weak constitution, they are more likely to sweat. In terms of treatment, early surgical intervention is advised to alleviate the sweating, and preparations should be made early on.
Why does patent ductus arteriosus cause a decrease in diastolic pressure?
In patients with patent ductus arteriosus, since the aortic pressure is significantly higher than the pulmonary artery pressure throughout the cardiac cycle, there is continuous blood flow from the aorta into the pulmonary artery through the open duct, causing a left-to-right shunt. This increases the blood volume in the pulmonary circulation, causing dilatation of the pulmonary artery and its branches. The blood flow returning to the left heart system also increases, thereby increasing the load on the left heart and causing the left heart to enlarge. Due to the diastolic diversion of blood from the aorta to the pulmonary artery, the peripheral arterial diastolic pressure decreases and the pulse pressure increases.
Can you have children if you have a patent ductus arteriosus?
The ductus arteriosus refers to a channel in the fetus that, before birth, allows blood from the maternal placenta to enter the fetus's aorta through the ductus arteriosus and then circulates the blood throughout the body. This channel closes after birth, and in the vast majority of people, it closes within a year. If it remains open until reproductive age, surgery is required because an open ductus arteriosus can lead to deteriorating heart function and, in severe cases, can cause heart failure. Therefore, women with an open ductus arteriosus can have children after treatment. An open ductus arteriosus is not a hereditary disease, and regardless of whether it is present in males or females, it is not genetic and they can have children.
How to treat patent ductus arteriosus?
The arterial duct connects the main pulmonary artery to the descending aorta, serving as the primary channel for blood circulation during the fetal period. After birth, it generally becomes obstructed within a few months due to disuse; if it remains open after one year, it is referred to as patent ductus arteriosus (PDA). The length and diameter of an unclosed arterial duct vary, affecting hemodynamics differently, and consequently, prognoses differ. An unclosed arterial duct can easily induce infectious endocarditis; thus, even if the shunt is small, it is advisable to seek early interventional or surgical treatment. The surgery has a high safety success rate and can be performed at any age. However, surgery is contraindicated for patients who have developed secondary pulmonary artery obstruction and exhibit right-to-left shunting.
Will patent ductus arteriosus increase with age?
Patent ductus arteriosus is a type of congenital heart disease, primarily treated through surgery. Early surgical intervention can completely cure this disease. However, as age increases, the symptoms of this disease can become more severe. Based on the patient's condition, it is recommended to undergo early surgical treatment at a hospital to alleviate the patient's suffering. As age increases, various organic diseases may emerge, which can sometimes affect a child's growth and development. During this period, it is advised that the patient regularly revisits the hospital for echocardiography checks and to also be cautious in preventing upper respiratory infections.