Treatment of patent ductus arteriosus in Türkiye

Patent ductus arteriosus is an abnormal and permanent opening between the aorta and the pulmonary artery in children. It is caused by non-closure of the ductus arteriosus after their birth. Small openings are harmless and do not cause problems, and therefore do not require medical intervention, but large ones need medical treatment because of the medical problems they cause, such as Weakening of the heart muscle , heart failure, and other complications, so its treatment is either by monitoring or closed by cardiac catheterization or surgery.

Symptoms of patent ductus arteriosus:

The small patent ductus arteriosus does not show any signs or symptoms and is not detected until puberty, but the large ones can cause signs of heart failure shortly after birth and are detected during the periodic examination by the pediatrician, specifically when the heartbeat is heard with a stethoscope, so we conclude that the symptoms differ depending on the size of the opening And if the baby was born early or at the right time.

The presence of a large patent ductus arteriosus during infancy or childhood causes:

• Malnutrition.
• Sweating while crying or eating.
• Rapid breathing or shortness of breath.
• Fatigue with little effort.
• tachycardia

the reasons

The ductus arteriosus develops normally in babies before birth between the aorta and the pulmonary artery, two large blood vessels that lead to the heart and are essential for blood circulation. Through it, the baby receives oxygen from the mother’s circulation. This opening usually closes within two or three days after birth or a little longer, but if it does not close, it is referred to as patent ductus arteriosus. This abnormal condition causes blood to circulate between the child’s lungs and heart, which increases pressure on the lungs ( pulmonary hypertension ), and the child’s heart may enlarge and weaken.

risk factors

Risk factors for infection include:

Premature birth : It occurs more commonly in babies who are born early than in babies who are born early.

Genetic family history : The risk of patent ductus arteriosus increases if there is a family history of heart defects and other genetic conditions such as Down syndrome. 

German measles infection during pregnancy: The risk of infection of the child increases if the mother is infected with German measles during pregnancy because the German measles virus crosses the placenta and spreads through the blood circulation of the child, leading to damage to blood vessels and organs, including the heart.

Born at high altitudes: Babies born above 2499 meters  have a higher risk of developing the disease than babies born at lower altitudes.

Gender of the baby: The disease is more common in girls than in boys.

complications

As mentioned above, small patent ductus arteriosus causes serious complications, but large ones cause the following:

High blood pressure in the lungs: Too much blood flowing through the main arteries of the heart through patent ductus arteriosus leads to pulmonary hypertension, which can cause permanent lung damage

Eisenmenger syndrome: A large patent ductus arteriosus can lead to this syndrome, which is a type of pulmonary hypertension.

Cardiac arrest : patent ductus arteriosus causes the heart to enlarge and weaken, leading to heart failure (a chronic condition in which the heart cannot pump blood effectively)

Heart infection (endocarditis): People with structural heart problems such as patent ductus arteriosus have a higher risk of developing inflammation of the inner lining of the heart.

Patent ductus arteriosus and pregnancy:

Most women who suffer from a small patent ductus arteriosus do not face any problems, but in the case of a large ductus arteriosus and associated complications such as heart failure, arrhythmias, or pulmonary hypertension, the risk of pregnancy complications increases, and pregnancy should be avoided in the case of Eisenmenger syndrome due to its threat for life. If the heart defects are treated or not, you should discuss with your doctor before pregnancy and get pre-conception counseling with doctors who specialize in congenital heart disease , genetics and high-risk obstetric care. It may be necessary to stop or adjust your medications before you become pregnant.

Prevention of patent ductus arteriosus:

There is no way to prevent having an infected baby, but all healthy pregnancy practices should be followed. Here are some basics:

• Seek early prenatal care and before pregnancy.
•  Quit smoking and reduce stress.
• Follow a healthy diet. 
• Take a multivitamin that contains folic acid.
• Exercising regularly.
• Avoid alcohol, cigarettes and drugs
•  Avoid hot tubs and saunas.
• Control of diabetes before and during pregnancy.
• Avoid infections as certain types of infections can be harmful to the fetus.

When should you get a doctor’s review:

Call the doctor if the infant or child experiences:

• Getting tired easily when eating or playing.
• not gaining weight
• The child gasps when eating or crying.
• Rapid breathing or shortness of breath.

Treatment of patent ductus arteriosus in Türkiye

Cardiovascular diseases remain the leading cause of death in most parts of the world. Studies in 2014 showed that these diseases were responsible for millions of deaths globally.

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The cardiovascular doctors and surgeons in REHABTÜRK have long experience and multidisciplinary teams to provide the best treatment for patients. 

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