Overview
Patent foramen ovale (PFO) is a heart condition where a small, flap-like opening in the atrial septum, which normally closes shortly after birth, remains open. This opening is called a foramen ovale, and in a PFO, it does not close properly. The foramen ovale is essential for fetal blood circulation, but in most cases, it closes properly after birth. When it remains open in an adult, it can lead to complications such as blood clots passing from the right atrium to the left atrium, potentially causing an embolism or stroke. PFO is usually diagnosed using echocardiography or a transesophageal echocardiogram (TEE). Treatment options may include medication to thin the blood or close the opening, such as using a device called a transcatheter closure device.
Understanding the disease
Development
Patent foramen ovale (PFO) develops when the foramen ovale, a small opening between the upper heart chambers, doesn't close properly after birth. This hole is present in all fetuses while they are in the womb, but it typically closes during infancy in most people. However, in some individuals, the foramen ovale fails to close, leading to the development of a PFO. The exact cause of this failure to close is not well understood, but it may have a genetic component. In most cases, a PFO doesn't cause any symptoms or complications and doesn't require treatment. However, in rare cases, a PFO can lead to low blood oxygen levels (hypoxemia) or a stroke, particularly in individuals who have a high-flow shunt through the PFO. A high-flow shunt occurs when a significant amount of blood passes through the PFO, bypassing the lungs and reducing oxygen levels in the blood.
Assessment and Diagnosis
Triage
You should see a doctor if patent foramen ovale is suspected if you experience symptoms such as low blood oxygen levels (hypoxemia) or if you have had a stroke, even if you have no other risk factors for stroke. Patent foramen ovale can be detected through various tests, including echocardiogram, transesophageal echocardiogram, cardiac MRI, or right heart catheterization. It's essential to consult a healthcare professional for proper evaluation and management of the condition.
Management and Treatment
Preparing for medical consultation
To prepare for an appointment for patent foramen ovale (PFO), you should be aware of any pre-appointment restrictions, write down any symptoms you're experiencing, including any that may seem unrelated to PFO, make a list of all medications you're taking, and consider bringing a family member or friend along for support. It's also important to make note of key personal information, including any major stresses or recent life changes, and prepare a list of questions to ask your healthcare provider. Some basic questions to ask include: "What's the most likely cause of my symptoms?", "What kinds of tests do I need?", "What treatment options are available?", and "Are there any dietary restrictions that I need to follow?".