Paediatrics: Persistent ductus arteriosus

Persistent ductus arteriosus

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.

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).