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Patient education: Patent foramen ovale (The Basics)

Patient education: Patent foramen ovale (The Basics)

What is a patent foramen ovale? — A patent foramen ovale, or "PFO," is a small opening inside the heart. The opening is between the upper 2 chambers of the heart, which are called the right atrium and left atrium (figure 1). A PFO lets blood flow between these chambers.

Before birth, when a baby is growing in the mother's uterus, an opening between the right atrium and left atrium is normal. It lets blood flow through the heart in the correct way. (The way blood flows through the heart before birth is different from the way it flows through the heart after birth.)

After birth, an opening between the right atrium and left atrium is not needed anymore. In most babies, the opening closes on its own soon after birth. But in some babies, it does not close. When this happens, doctors call it a PFO. This is very common. About 1 out of every 4 people has a PFO. Doctors don't know what causes a PFO.

What are the symptoms of a PFO? — Most people have no symptoms or problems from their PFO. Some people might find out they have it when their doctor does a test for another reason.

In some cases, a PFO can lead to problems. Although uncommon, some PFOs can lead to a stroke. A stroke is when a part of the brain is damaged because of a problem with blood flow. It can cause problems with speaking, thinking, or moving the arms or legs.

A PFO can lead to a stroke in the following way: A blood clot can form in a leg vein. The blood clot can travel through the blood to the heart. It then enters the right atrium. If a person has a PFO, the blood clot can then flow into the left atrium. From there, it flows into the left ventricle and then to the body or brain. A blood clot that travels to the brain can cause a stroke.

Is there a test for a PFO? — Yes. The test done most often to check for a PFO is an echocardiogram (also called an "echo") (figure 2). This test uses sound waves to create pictures of the heart as it beats.

Your doctor will likely do a test called a "bubble test" with your echo. They will put some salt water (that has bubbles) into your vein through a thin tube called an "IV." Then your doctor will do an echo to watch how the bubbles flow through your heart.

People might have tests to check for a PFO if they have a stroke and their doctor can't find a cause of the stroke.

How is a PFO treated? — Treatment depends on whether your PFO causes symptoms or not.

If your PFO causes no symptoms, it does not need treatment.

If you had a stroke that could have been caused by your PFO, your doctor will talk with you about possible treatments. These might include:

Medicines, including aspirin or other medicines to prevent blood clots

A procedure or surgery to close your PFO

Your doctor might also recommend things you can do on your own to prevent blood clots in your legs. To help prevent blood clots in your legs, you can:

Avoid sitting or standing still in the same position for a long time

Stand up and walk around every 1 to 2 hours, including when you take long trips by car, train, or plane

Change your position when you are sitting, and move your legs and feet often

Not smoke

More on this topic

Patient education: Echocardiogram (The Basics)
Patient education: Stroke (The Basics)
Patient education: Atrial septal defects in children (The Basics)
Patient education: Deep vein thrombosis (blood clot in the leg) (The Basics)

Patient education: Stroke symptoms and diagnosis (Beyond the Basics)
Patient education: Deep vein thrombosis (DVT) (Beyond the Basics)

This topic retrieved from UpToDate on: Jun 02, 2024.
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