Patent Ductus Arteriosus: Echocardiographic Features and Diagnosis

During fetal development, the ductus arteriosus remains open to support the circulatory system. Normally, it closes within 6 to 12 months after birth. In many cases, a small open duct may be detected in newborns, which often requires only regular monitoring as it may close naturally. However, if the duct remains open beyond this period, it results in a condition known as patent ductus arteriosus (PDA), which typically requires medical or surgical intervention.

Understanding Patent Ductus Arteriosus

Patent ductus arteriosus is one of the most common congenital heart defects, accounting for approximately 12% to 15% of all such cases. It is significantly more prevalent in females, affecting them nearly twice as often as males. In about 10% of PDA cases, it occurs alongside other cardiovascular anomalies, including coarctation of the aorta, atrial septal defect, ventricular septal defect, and more complex congenital heart conditions.

Diagnostic Approach Using Echocardiography

Echocardiography, particularly color Doppler imaging, plays a crucial role in diagnosing PDA. During the examination, cardiologists often observe signs such as left ventricular enlargement and an abnormal communication between the pulmonary artery and the descending aorta. A hallmark finding is the presence of turbulent blood flow from the aorta to the pulmonary artery, which can be clearly visualized using color flow mapping.

In addition to imaging, a characteristic finding during physical examination is a continuous "machinery-like" heart murmur, heard throughout both systole and diastole. This murmur is caused by the continuous shunting of blood through the open ductus arteriosus.

Treatment Options for PDA

When PDA does not close spontaneously, treatment options include both interventional and surgical approaches. Catheter-based closure using a closure device is a minimally invasive option commonly used in appropriate candidates. Alternatively, surgical ligation or repair may be recommended for larger defects or in cases where interventional methods are not suitable. Early diagnosis through echocardiography and timely treatment are essential in preventing long-term complications such as heart failure or pulmonary hypertension.