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congenital heart disease fetus
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Ductus arteriosus
Ductus arteriosus (PDA) is a congenital heart defect in which the channel arteriosus a child does not close after birth. Symptoms are rare, but in the first year of life include increased work of breathing and poor weight gain. In older children or adults, the PDA can lead to congestive heart failure if not corrected.
Overview
Full stop ductus arteriosus
In the developing fetus, the ductus arteriosus (DA) is vascular connection between the pulmonary artery and aortic arch that allows most blood from the right ventricle to prevent the compressed liquid filled the fetal lungs. During fetal development, this shunt protects the right ventricle pumping against a high resistance in the lungs, which can lead to right ventricular failure if the prosecutor starts in the womb.
When the baby takes its reduced resistance to first breath, the lungs open and pulmonary vascular. After birth, the lungs release bradykinin constriction of the DA wall smooth muscle and reduce blood flow in the DA, because the close and not close completely, usually within the first weeks of life. In most infants with patent ductus arteriosus blood flow is reversed flow in the uterus, for example. blood flow increases the pressure in the aorta now low pressure pulmonary arteries.
In the normal newborn, the prosecutor is substantially closed within 12-24 hours after birth, and is completely sealed after three weeks. The fall of prostaglandins in the maternal circulation contributes. The scar tissue is fibrous residual DA, called the ligamentum arteriosum, remains in the normal adult heart.
Persistence ductus arteriosus
The ductus arteriosus, or PDA is a heart condition which is normal, but was overthrown shortly after birth. In a persistent PDA, there is an irregular transfer of blood between two of the most important arteries in the vicinity of the heart. Although the ductus arteriosus normally closed some days in the PDA, patent ductus arteriosus of the newborn baby is not closed, but remains patent. PDA is common in infants respiratory problems such as hypoxia and has a high impact on premature babies. In the hypoxic newborns, too little oxygen reaches the lungs to produce sufficient levels of bradykinin and the subsequent closure of the DA. Children Premature babies are more likely to be hypoxic and therefore have PDA because his heart and lungs underdeveloped.
The ductus arteriosus allows some oxygenated blood from the heart to the left to flow into the lungs (as the pressure gradient in the aorta increased pressure in the pulmonary arteries). If this amount differentiation is important, the child becomes difficult to breathe because there is not only the normal amount of oxygenated blood that has returned the body to go to the lungs, but it is also the amount diverted through the PDA. The work of breathing of the baby is more, the calories eat more and often interferes with nutrition in childhood. This condition as a constellation of findings known as heart failure failure.
In some cases, such as transposition of great arteries (pulmonary artery and aorta), a PDA may need to remain open. In this condition cardio-vascular, the PDA is the only way that oxygenated blood can mix with the blood without oxygen. In these cases, prostaglandins are used for keep open the ductus arteriosus.
Signs and symptoms
While some cases of PDA are asymptomatic, common symptoms include:
- tachycardia or other arrhythmia
- breathing problems
- breathlessness
- continuous machine-like murmur
- enlarged heart
Diagnosis
PDA is usually diagnosed by noninvasive techniques. Echocardiography, in which sound waves are used to capture the motion of the heart and is associated Doppler studies are the main methods of detection of the PDA. Electrocardiogram (ECG), in which electrodes are used to record the electrical activity of the heart, not particularly useful because it is not specific rhythms or ECG patterns that can be used to detect the PDA.
A chest radiograph can be taken which revealed heart size of the baby (as a reflection of the combined mass of the heart chambers) and the appearance of blood flow to the lungs. A small PDA is most often size shows a normal heart and normal circulation of blood to the lungs. A large PDA will usually show an enlarged cardiac silhouette and increased blood flow to the lungs.
Treatment
Babies without adverse symptoms may simply be monitored on an outpatient basis, while PDA symptomatic may be treated with methods of both surgical and nonsurgical. <ref> Zahaka, KG, Patel CR. "Birth defects". Fanaroff, AA and Martin RJ (eds). Neonatal and perinatal medicine: Diseases of the fetus and infant. 7th ed. (2002) :1120-1139. St. Louis: Mosby. </ Ref> surgically, the prosecutor may be closed by ligation, in which the tax is tied by hand or with intravascular coils or plugs which leads to thrombus formation in AD. Fluid restriction and prostaglandin inhibitors like indomethacin have also been used successfully in non-surgical closure of the DA. This is a viable alternative, especially for premature babies.
In some cases it may be beneficial for the newborn to prevent closure of the ductus arteriosus. For example, in the transposition of the great vessels of a PDA can prolong life child until surgical correction is possible. The ductus arteriosus may have to remain open to the administration of similar prostaglandins such as alprostadil (an analog of prostaglandin E1).
Last Days PDA may be closed by percutaneous intervention method, through the femoral vein or femoral artery, a coil may be placed using forceps myocardial for a piston, which closes the PDA without need of open heart surgery.
Learn more
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About the Author
Theron M Claude is Editor of Diseaseopedia.com, the webs most comprehensive medical encyclopedia.
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