PFO or patent foramen ovale is a condition where there’s a hole in the septum or wall of the heart between the atria or upper chambers. Actually, an opening between the upper chambers of the heart is normal during fetal development, but it eventually closes up after the baby’s born. Sometimes, the hole stays open and then is known as a patent foramen ovale.
Though a hole in the heart sounds daunting, a lot of people have it and don’t know it, because it doesn’t cause them trouble. Medical professionals aren’t quite sure why the hole doesn’t close up in some people.
Even though PFO isn’t a problem for most people who have it, it’s been implicated in people who have a stroke for no reason a physician can discover. This is called a cryptogenic stroke. Some doctors believe that a blood clot travels through the PFO then continues on to the brain and causes the stroke. PFO has also been seen in people who have migraine headaches with auras. These are bright flashes of light or zigzag lines in the field of the person’s vision just before the headache starts.
There are several tests to see if a patient has a PFO. An echocardiogram will let the doctor see how the patient’s heart is built and how it’s functioning. Another test is a color flow Doppler, a test that uses sound waves to test how blood is flowing through the heart. If the patient has a patent foramen ovale, this test will detect it, as it will sense the blood moving between the atria. A bubble study can also show if there’s a PFO. A medical professional injects a bubbly saline solution into the patient’s vein. If there’s a PFO, the test will show bubbles in the left atrium.
Another echocardiogram can be inserted down the esophagus to see if a PFO is present. This test is useful because the esophagus is close to the heart. The test is often used with the Doppler or saline bubble test.
A doctor might recommend that a child with PFO have it closed if the child has another defect in his or her heart that needs surgery. An adult might want to have the PFO closed if he or she is also having heart surgery or because the levels of oxygen in the blood are low.
A doctor can close the PFO through catheterization. The catheter is threaded up through a vein to the heart and a device is used to plug the hole. Or, the heart can be opened up and the PFO can be stitched shut.