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. The condition is relatively common.
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 within the first or second year of life. When the foramen ovale doesn't close, it's called a patent foramen ovale.
Most people with a patent foramen ovale 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 condition.
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.
Rarely, an infant with a patent foramen ovale might have bluish skin (cyanosis) when crying or straining, such as when passing stool. When an infant with a patent foramen ovale has cyanosis, he or she usually has other heart defects.
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 within the first or second year of life.
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....
In most people, a patent foramen ovale doesn't cause complications. The disorder has been associated with other conditions, such as stroke and migraine, but it's unknown whether or not patent foramen ovale is a potential cause of these conditions. Possible complications linked to patent foramen ovale include:
Migraine with aura
Preparing for your appointment
In most cases, a patent foramen ovale is discovered during imaging tests to examine other heart conditions or to look for causes of stroke. Your doctor may also suspect a heart defect, such as a patent foramen ovale, if he or she hears an unusual sound (heart murmur) when listening to your heart.
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 will 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 stroke or to treat migraines is controversial right now and is being studied in clinical trials. Closure of the patent foramen ovale is sometimes recommended for individuals with recurrent strokes when no other cause has been found.
Surgical and other procedures for closure
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.
But, be sure to consult your doctor before undertaking activities that might limit your levels of oxygen, such as scuba diving or mountain climbing. People with a patent foramen ovale may be more likely to get decompression sickness when scuba diving or a life-threatening form of altitude sickness called high-altitude pulmonary edema when mountain climbing.
Coping and support
Learning that you or your child has a patent foramen ovale can be frightening. While your doctor can provide you with medical advice and information about the disorder, you may find it helpful to talk to other people who've been in the same situation. Support groups include Mended Hearts for people who have survived heart disease and Mended Little Hearts for parents of children with congenital heart problems. Call the American Heart Association at 800-AHA-USA1 (800-242-8721) and ask for Mended Hearts support or visit its website. Mended Hearts can also be reached on weekdays at 888-HEART99 (888-432-7899). You can also ask your doctor or your child's doctor if he or she knows of any support groups in your area.
Last Updated: 2010-07-13
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