Open ductus arteriosus in newborns treatment, symptoms, diagnosis

Diagnosis of OAP, on the one hand, is simple, since an accurate method such as ultrasound and dopplerography is enough to accurately determine. On the other hand, infants are subjected to additional studies only if necessary, if there is reason for suspicion.

AOP, especially if the width of the unclosed duct is small, is asymptomatic and is often diagnosed randomly when other diseases are treated – pneumonia, bronchitis and others. The latter with this diagnosis are accompanying diseases.

In the fetus, the difference between the pressure in the pulmonary artery and the aorta causes the discharge of blood from left to right, facilitating the work of the right ventricle of the heart. In adults, with wide AOP, pulmonary resistance increases, and blood discharge changes direction – from right to left, that is, an additional portion of blood gets into the small circle of blood circulation, overflowing the lung tissue.

With a narrow AOP without changing the discharge of blood, the disease may not manifest itself in any way. In general, this option does not affect life expectancy. In women with narrow and medium OAP, from left to right, even pregnancy proceeds without complications. A dangerous ailment is considered due to an increased risk of endocarditis of an infectious origin.

A different picture is observed when changing the discharge of blood. To cope with excess fluid, the left ventricle of the heart is forced to work too intensively, and pressure increases in the vessels of the lungs to compensate.

As a result, blood stagnation develops in the lungs, and the left ventricle hypertrophies. The longer the disease develops, the greater the deformation of the heart and lungs of the child.

Such overloads are accompanied by all relevant inflammatory diseases – the same bronchitis, colds, pneumonia, since a small patient is susceptible to such ailments due to poor outflow of blood from the lungs. Treatment of only these “external” manifestations gives little. However, as early as six months, the child has other symptoms that make it possible to suspect AOP and conduct additional studies.

The most serious consequences of the disease include the following complications:

  • Heart failure – its development is obvious, since the left ventricle works with a high load, which, accordingly, leads to disturbances in the work of the heart.
  • Pulmonary edema is the last stage of blood stasis in the lungs. However, if you ignore the treatment, such a complication is possible.
  • A heart attack is a necrosis of the heart, which is deadly for both children and adults.
  • Aneurysm – expansion of the open duct and its rupture. Damage and rupture of the aorta are possible, which is incompatible with life.
  • Bacteriological endocarditis is an inflammation of the inner heart membrane, fraught with impaired valve function and other complications.
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You can avoid all these consequences by starting treatment on time. Moreover, with a small duct width – up to 4 mm, and an early stage of detection, treatment can also be carried out medically, using drugs that stimulate closure. Surgical intervention, as a rule, is undertaken upon reaching the child’s one-year-old age.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.