Early diagnosis and medical treatment of the persistent ductus arteriosus in infants.

Diagnosis of an isolated patent ductus arteriosus (PDA) is usually straightforward. If at later age it is associated with pulmonary hypertension, however, the symptoms may be variable and more difficult to assess. In the age group primarily discussed here, pulmonary hypertension is frequently present, so diagnosis cannot be based on physical findings alone. Echocardiography and Doppler echocardiography are essential diagnostic procedures; however, cardiac catheterization and angiography may still be needed especially in cases with associated heart defects. At present, surgical closure of the PDA is the therapy of choice in infants. In preterm newborns, an attempt by medical treatment is indicated and often promising. Unfortunately, there are no interventional techniques available at present for duct closure in this age group, whereas in some centers catheter closure of a PDA is successfully employed in older children.