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What is a Patent Foramen Ovale?
As many as one person in four has a small hole in their heart called a patent foramen ovale (PFO.) Before we are born we all have a hole in our hearts, and shortly after birth this hole closes 75 percent of the time. For the remaining 25 percent the hole does not completely close and it is called a patent foramen ovale. In one percent of people a larger hole remains called an atrial septal defect. Sometimes the hole closes, but the membrane is redundant, which is called an inter-atrial septal aneurysm.
A PFO can allow for a small blood clot or air bubble to travel from the right side of the heart, directly to the left side of the heart. If a blood clot or air bubble is on the left side of the heart it can cause a stroke or TIA, or damage other internal organs.
What are the symptoms of a Patent Foramen Ovale?
For the majority of people who have a PFO it causes no symptoms. It can however be related to a stroke or TIA, especially in younger people who are not conventionally at risk for stroke. There may also be a link between migraine headaches and patent foramen ovale.
How do you diagnose a Patent Foramen Ovale?
A patent foramen ovale is diagnosed by performing an echocardiogram. Under certain circumstances a Transesophageal Echocardiogram may be required to make the diagnosis of a PFO. An Intracardiac Echocardiogram may need to be performed in special circumstances.
How is it treated?
For the majority of people with a diagnosed PFO it can be treated with blood thinners. For some patients a cardiologist or neurologist may recommend closing the patent foramen ovale. The PFO can be closed by a cardiac surgeon using a small incision. It can also be closed during a cardiac catheterization, using specialized balloons to determine the size of the defect, and a specialized closure device placed inside the heart to close the hole. Scuba diving is not allowed when you have a patent foramen ovale since there is an increased risk of stroke.
