Patent ductus arteriosus is when the ductus arteriosus fails to close after birth. This causes a left to right shunt in the heart, where oxygenated blood passes through the duct and into the lungs instead out into the systemic circulation. A large enough shunt typically presents one of two major ways:

Early on in the first few weeks of life with pulmonary oedema and often congestive cardiac failure from the extra pulmonary blood flow and subsequent extra flow and straint on the left heart.
After years of extra pulmonary blood flow which causes pulmonary hypertension which reverses the shunt, making it right to left. This causes deoxygenated blood to flow into the systemic circulation and can cause cyanosis, usually of the lower part of the body as the aortic branches to the upper body usually branch off proximal to the ductus.

Early management of a PDA involves watchful waiting, medications like indomethacin and ibuprofen, or surgical closure.

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(This isn’t individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

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