It depends on age, maturity of newborn, weight of baby and the size of PDA.
- Preterm babies especially less than 1500 grams (1.5 Kg) can present as signs of heart failure, multiple episodes of apnea, dependency on oxygen/ventilator etc.
- Large PDA can lead to heart failure, decrease in blood pressure (diastolic blood pressure) that can leads to poor blood perfusion in various organs of the body.
- Large PDA babies are prone for the development of pulmonary vascular disease which is irreversible to treat PDA.
- Hypoperfusion may lead to renal impairment, necrotizing enterocolitis, feeding intolerance, and hemorrhage in brain.
- Newborns that are mature and having good weight at birth are generally not having any symptoms due to PDA itself.
- In small sized PDA, child is generally asymptomatic and comes to know by a pediatrician by hearing an abnormal heart sound (murmur) on routine examination.
- Moderate to large sized PDA are generally asymptomatic in first few days of life.
- Around 1-2 months of age, child can present as feeding difficulty, sweating over forehead, suck-rest-suck cycle on feeding, poor weight gain etc. Sometimes, child if not treated, can have signs of pneumonia including hospital admission and occasional requirement of ventilator.