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 â the foramen ovale (foh-RAY-mun oh-VAY-lee) â is normally present in the wall between the right and left upper chambers of the heart (atria). It normally closes during infancy. When the foramen ovale doesn't close, it's called a patent foramen ovale.
Patent foramen ovale occurs in about 25 percent of the normal population, but 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 concerning, but most people never need treatment for this disorder.
Source: http://www.mayoclinic.com
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.
Source: http://www.mayoclinic.com
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.
Your heart has four pumping chambers that circulate your blood:
Because a baby in the womb isn't breathing, the lungs aren't functioning yet. That means there's no need to pump blood to the lungs. At this stage, it's more efficient for blood to bypass the lungs and use a different route to circulate oxygen-rich blood from the mother to the baby's body.
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.
When a baby's lungs begin functioning, the circulation of blood through the heart changes. Now the oxygen-rich blood comes from the lungs and enters the left atrium. At this point, blood circulation follows the normal circulatory route.
The pressure of the blood pumping through the heart usually forces the flap opening of the foramen ovale closed. In most people, the opening fuses shut, usually sometime during infancy.
Source: http://www.mayoclinic.com
A doctor trained in heart conditions (cardiologist) may order one or more of the following tests to diagnose a patent foramen ovale:
An echocardiogram shows the anatomy, structure and function of your heart.
A common type of echocardiogram is called a transthoracic echocardiogram. In this test, sound waves directed at your heart from a wandlike device (transducer) held on your chest produce video images of your heart in motion. Doctors may use this test to diagnose a patent foramen ovale and detect other heart problems.
Variations of this procedure may be used to identify patent foramen ovale, including:
Color flow Doppler. When sound waves bounce off blood cells moving through your heart, they change pitch. These characteristic changes (Doppler signals) and computerized colorization of these signals can help your doctor examine the speed and direction of blood flow in your heart.
If you have a patent foramen ovale, a color flow Doppler echocardiogram could detect the flow of blood between the right atrium and left atrium.
Saline contrast study (bubble study). With this approach, a sterile salt solution is shaken until tiny bubbles form and then is injected into a vein. The bubbles travel to the right side of your heart and appear on the echocardiogram.
If there's no hole between the left atrium and right atrium, the bubbles will simply be filtered out in the lungs. If you have a patent foramen ovale, some bubbles will appear on the left side of the heart. The presence of a patent foramen ovale may be difficult to confirm by a transthoracic echocardiogram.
Doctors may conduct another type of echocardiogram called a transesophageal echocardiogram to get a closer look at the heart and blood flow through the heart. In this test, a small transducer attached to the end of a tube is inserted down the tube leading from your mouth to your stomach (esophagus).
This is generally the most accurate available test for doctors to see a patent foramen ovale by using the ultrasound in combination with color flow Doppler or a saline contrast study.
Your doctor may recommend additional tests if you're diagnosed with a patent foramen ovale and you have had a stroke. Your doctor may also refer you to a doctor trained in brain and nervous system conditions (neurologist).
Source: http://www.mayoclinic.com
Generally, a patent foramen ovale doesn't cause complications. But some studies have found the disorder is more common in people with certain conditions, such as unexplained strokes and migraines with aura.
In most cases, there are other reasons for these neurologic conditions, and it's just a coincidence the person also has a patent foramen ovale. However, in some cases, small blood clots in the heart may move through a patent foramen ovale, travel to the brain and cause a stroke.
The possible link between a patent foramen ovale and a stroke or migraine is controversial, and research studies are ongoing.
In rare cases a patent foramen ovale can cause a significant amount of blood to bypass the lungs, resulting in low blood oxygen levels (hypoxemia).
In decompression illness, which can occur in scuba diving, an air blood clot can travel through a patent foramen ovale.
In some cases, other heart defects may be present in addition to a patent foramen ovale.
Source: http://www.mayoclinic.com
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.
Source: http://www.mayoclinic.com
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