PFOs are more likely in newborns who have a congenital heart defect. A patent foramen ovale most often is seen on an echocardiogram ultrasound of the heart being done for other reasons. PFOs usually aren't treated unless there's another reason for heart surgery or someone's risk for blood clots or stroke is higher than average. A PFO may increase the risk of strokes because tiny blood clots elsewhere in the body can break loose and go to the heart via the blood.
These tiny clots are usually filtered out of the blood by the lungs. In a person with a PFO, the clot can slip from the right atrium to the left atrium. From there, the clot goes to the left ventricle, which sends the clot out to the body or the brain, where it can affect organs that are much more sensitive to injury than the lungs. When a blood clot blocks blood flow to part of the brain, the result is a stroke.
Even in a person who has had a stroke, treatment usually focuses on preventing clots rather than closing the PFO. If closure is required, cardiac catheterization can be used to place a device through a long, thin tube guided through blood vessels to the heart to close the foramen ovale. PFOs aren't likely to cause trouble and need no special treatment for most people. But kids and adults should know that they have one if it is diagnosed.
Blood is also sent to the lower body. Blood returning to the heart from the fetal body contains carbon dioxide and waste products as it enters the right atrium. It flows down into the right ventricle, where it normally would be sent to the lungs to be oxygenated.
Instead, it bypasses the lungs and flows through the ductus arteriosus into the descending aorta, which connects to the umbilical arteries. From there, blood flows back into the placenta. There the carbon dioxide and waste products are released into the mother's circulatory system.
Oxygen and nutrients from the mother's blood are transferred across the placenta. Then the cycle starts again. At birth, major changes take place.
However, if your doctor feels a diagnosis is necessary, they may recommend an echocardiogram. This technique uses sound waves to get an image of your heart. In this test, they inject a saltwater solution during the echocardiogram. Your doctor then watches to see if bubbles pass between the two chambers of your heart. In most cases, people with PFO have no symptoms or complications. PFO is usually not a concern unless you have other heart conditions.
There is some evidence that adults with PFO may have a higher risk of stroke. But this is still controversial, and research is ongoing. 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 your brain. Strokes can be minor or very serious. Small blood clots may pass through the PFO and get stuck in the arteries of the brain in some people. 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.
A PFO can be closed by a catheterization procedure. In this procedure, your surgeon inserts a plug into the hole using a long tube called a catheter that is usually inserted at your groin.
A PFO can be closed surgically by making a small incision, and then stitching the hole closed. Sometimes a doctor can repair the PFO surgically if another heart procedure is being done. Medication to thin 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.
If you need surgery for a PFO, you should expect to recover fully and live a normal and healthy life.
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