A foramen ovale is a hole in the heart. It normally exists in babies who are still in the womb. It should close soon after birth. If it doesn’t close, the condition is called patent foramen ovale (PFO).
PFOs are common. They occur in roughly one out of every four people. If you have 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 called 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 doesn’t use their own lungs. Instead, they rely on the mother to oxygenate their blood. The foramen ovale helps blood circulate more quickly in the absence of lung function.
When your baby is born and their lungs begin to work, the 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 majority of cases, PFO causes no symptoms.
In very rare cases, an infant with PFO could have a blue tint to their skin when crying or passing stool. This is called cyanosis. It usually only occurs if the baby has both PFO and another heart condition.
Most of the time, there’s no need to pursue the diagnosis of a PFO. However, if your doctor feels a diagnosis is necessary, an echocardiogram may be performed. This technique uses sound waves to get an image of the heart.
If your doctor cannot see the hole on a standard echocardiogram, they may perform a bubble test. In this test, the inject a saltwater solution during the echocardiogram. Your doctor then watches to see if bubbles pass between the two chambers of the heart.
In most cases, people with PFO have no symptoms or complications. 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.
An ischemic 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 people who have had a PFO surgically corrected report a reduction in migraines.
In most cases of PFO, no treatment is necessary.
A PFO may be closed surgically if another heart procedure is being done. The hole can be closed by catheterization. In this procedure, your surgeon inserts a plug into the hole using a long tube called a catheter. They then stitch the hole closed.
Adults with PFO who’ve had blood clots or strokes may need surgery to close the hole. Medication to thin the blood and prevent clots from forming may also be prescribed instead of surgery.
The outlook for people with PFO is excellent. Most people will never even realize they have a PFO. Although stroke and migraines are possible complications of PFO, they aren’t common.
If you need surgery for a PFO, you should expect to recover fully and live a normal and healthy life.