What is the first-line treatment for patent ductus arteriosus?

Indomethacin is commonly recognized as the first-line treatment for patent ductus arteriosus (PDA), particularly in premature infants. This nonsteroidal anti-inflammatory drug (NSAID) works by inhibiting prostaglandin E synthesis, which is crucial for keeping the ductus arteriosus open. In premature infants, where the ductus arteriosus may remain patent and lead to increased pulmonary blood flow and congestive heart failure, indomethacin effectively helps to promote closure of the ductus by decreasing levels of circulating prostaglandins that maintain its patency.

In cases where the PDA is persistent, especially in larger or symptomatic PDAs, other treatment options such as surgical ligation may be considered. However, this is more often reserved for situations where medical management fails, rather than being a first-line therapy.

Prostaglandin E1 is used in conditions where maintaining ductal patency is necessary, such as in specific congenital heart defects that require blood flow through the ductus arteriosus for adequate circulation. This option does not address the closure of a PDA.

Diuretics are primarily used to manage heart failure symptoms that can arise from the hemodynamic consequences of a significant PDA but are not a