A foramen ovale is a hole in the heart. It normally exists while babies are in the womb but should close soon after birth. If it does not close, the condition is called patent foramen ovale (PFO). PFOs are common. They occur in one of every four people.
If there are no other heart conditions or complications, treatment for PFO is unnecessary.
While a fetus develops in the womb, a small opening exists between the two upper chambers of the heart (the atria). This opening is called the foramen ovale. The purpose of the foramen ovale is to help circulate blood through the heart. A fetus does not use its own lungs. Instead, it relies on the mother to oxygenate the blood. The foramen ovale helps blood circulate more quickly in the absence of lung function.
When a baby is born and the lungs begin to work, pressure inside the heart usually causes the foramen ovale to close. It may not happen for a year or two. In some people, the closure may never happen at all, resulting in PFO.
In the vast majority of cases, PFO causes no symptoms. In very rare cases, an infant with PFO could have a blue tint to the skin when crying or passing a stool. This is called cyanosis. It usually only occurs if the infant has both PFO and another heart condition.
Most of the time, there is no need to pursue the diagnosis of a PFO. However, if your doctor feels a diagnosis is necessary, an echocardiogram may be performed. This is a technique that uses sound waves to image the heart.
If the hole cannot be seen on a standard echocardiogram, a bubble test may be performed. In this test, saltwater solution is injected during the echocardiogram. The doctor then watches to see if bubbles pass between the two chambers of the heart.
In most cases, there are no symptoms and no complications in individuals with PFO. PFO is usually not a concern unless you have other heart conditions.
PFO and Strokes
There is some evidence that adults with PFO may have a higher risk of stroke.
A stroke occurs when part of the brain is denied blood. This may happen if a clot becomes trapped in one of the arteries of the brain. Strokes can be minor or very serious.
Some people with PFO may be more likely to form blood clots. Clots may also be more likely to pass through the PFO and get stuck in the arteries of the brain. However, most people with PFO will not have a stroke.
PFO and Migraines
There may be a connection between PFO and migraines. Migraines are very severe headaches that can be accompanied by blurred vision, shimmering lights, and blind spots. Some patients who have had a PFO surgically corrected report a reduction in migraines (Mayo Clinic).
In most cases of PFO, no treatment is necessary.
A PFO may be closed surgically if another heart procedure is being conducted. The hole can be closed by catheterization, where a plug is inserted into the hole using a long tube called a catheter. The hole can also be stitched closed by a surgeon.
Adult patients with PFO who have experienced blood clots or strokes may need surgery to close the hole. Medication to thin the blood and prevent clot formation may also be prescribed instead of surgery.
The outlook for a PFO is excellent. Most people will never even realize they have a PFO.
Although stroke and migraines are possible complications of PFO, they are not common.
If you need surgery for a PFO, you should expect to recover fully and live a normal and healthy life.