Patent foramen ovale
Patent foramen ovale
A patent foramen ovale (PFO) is a hole in the heart that didn't close the way it should after birth.
During fetal development, a small flap-like opening — the foramen ovale (foh-RAY-mun oh-VAY-lee) — is usually present between the right and left upper chambers of the heart. It normally closes during infancy. When the foramen ovale doesn't close, it's called a patent foramen ovale.
Although it's common to have a patent formen ovale, most people with the condition never know they have it. A patent foramen ovale is often discovered during tests for other problems. Learning that you have a patent foramen ovale is understandably worrisome, but most people never need treatment for this disorder.
Most people with a patent foramen ovale don't know they have it, because it's usually a hidden condition that doesn't create signs or symptoms.
It's unclear what causes the foramen ovale to stay open in some people, though genetics may play a role.
An overview of normal heart function in a child or adult is helpful in understanding the role of the foramen ovale before birth.
Normal heart function
Baby's heart in the womb
The umbilical cord delivers oxygen-rich blood to the baby's right atrium. Most of this blood travels through the foramen ovale and into the left atrium. From there the blood goes to the left ventricle, which pumps it throughout the body. Blood also travels from the right atrium to the right ventricle, which also pumps blood to the body via another bypass system.
Newborn baby's heart
The pressure of the blood pumping through the heart usually forces the foramen ovale closed. In most people, the opening fuses shut, usually sometime during infancy.
Patent foramen ovale
Patent foramen ovale is a small, flap-like opening in the wall between the right and left upper chambers of the heart. It usually causes no signs or symptoms and rarely requires treatment. ...
Generally, a patent foramen ovale doesn't cause complications. But, some studies have found the disorder is more common in individuals with certain conditions, such as unexplained stroke and migraine with aura. In most cases, there are other reasons for these conditions, and it's just a coincidence the person also has a patent foramen ovale. However, in some cases, blood clots in the heart may move through a patent foramen ovale, travel to the brain and cause a stroke. When this happens, it's often in people with conditions that increase the risk of blood clots, such as cancer.
The possible link between patent foramen ovale and stroke or migraine is controversial and research studies are ongoing.
In some cases a patent foramen ovale can cause a significant amount of blood to bypass the lungs, resulting in low blood oxygen levels (hypoxia). This usually happens when other conditions are present, such as congenital or valvular heart disease or pulmonary hypertension.
Preparing for your appointment
A patent foramen ovale is often discovered during imaging tests for other conditions or to look for causes of stroke.
After a patent foramen ovale has been diagnosed, you'll likely have numerous questions for your doctor. Some questions you may want to ask include:
Tests and diagnosis
A heart specialist (cardiologist) can detect a patent foramen ovale with one of the following tests:
With this test, a technician spreads gel on your chest and then presses a device called a transducer against the skin over the heart. The transducer emits high-pitched sound waves and records the sound wave echoes as they reflect off internal structures in the heart. A computer converts the echoes into moving images on a monitor. Variations of this procedure may be used to identify patent foramen ovale:
Treatments and drugs
Most people with a patent foramen ovale don't need treatment. In certain circumstances, however, your doctor may recommend that you or your child have a procedure to close the patent foramen ovale.
Reasons for closure
Closure of a patent foramen ovale to prevent migraines isn't currently recommended. Closure of a patent formaen ovale to prevent a stroke remains controversial. Closure may be recommended for individuals with recurrent strokes despite medical therapy, when no other cause has been found.
Surgical and other procedures for closure Procedures to close patent foramen ovale include:
Lifestyle and home remedies
If you know you have a patent foramen ovale, but don't have symptoms, you probably won't have any restrictions on your activities.
If you'll be traveling long distances, it's important to follow recommendations for preventing blood clots. If you're traveling by car, stop periodically and go for a short walk. On an airplane, be sure to stay well hydrated and walk around whenever it's safe to do so.
Last Updated: 2012-11-01
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