Patent Foramen Ovale
Also known as: Persistent Foramen Ovale or PFO
Patent Foramen Ovale (PFO) is a congenital heart defect that occurs when the foramen ovale, a small flap-like opening between the right and left atria of the heart, fails to close properly after birth. This opening is present in the foetal heart to allow blood to bypass the lungs, but it typically closes shortly after birth. In some individuals, the foramen ovale remains open, allowing blood to pass from the right atrium to the left atrium. This can potentially allow blood clots or other substances to bypass the filtering system of the lungs and travel to the brain, leading to various medical conditions.
What are the symptoms of Patent Foramen Ovale?
In many cases, PFO may not cause any symptoms and may go undetected for years. However, it can be associated with certain medical conditions, including:
Cryptogenic stroke (a stroke of unknown cause): PFO is more prevalent in individuals who have had a cryptogenic stroke, particularly in younger patients.
Migraine with aura: Some studies have suggested a potential link between PFO and migraine headaches, particularly migraine with aura.
Decompression illness: PFO has been associated with an increased risk of decompression illness (such as "the bends") in scuba divers, as it may allow bubbles to travel from the venous circulation to the arterial circulation.
How is Patent Foramen Ovale diagnosed?
Diagnosis of PFO typically involves a combination of medical history, physical examination, and diagnostic tests, which may include:
Transesophageal echocardiogram (TEE):
This specialised ultrasound test uses a probe inserted into the oesophagus to obtain detailed images of the heart and detect the presence of a PFO.
Transthoracic echocardiogram (TTE):
This non-invasive ultrasound test uses a probe placed on the chest to evaluate heart structure and function, though it may be less sensitive for detecting PFO compared to TEE.
Contrast-enhanced echocardiography:
During an echocardiogram, a contrast agent may be injected into a vein to enhance visualisation of blood flow through the heart and detect the presence of a PFO more effectively.
How is Patent Foramen Ovale treated?
Treatment for PFO may vary depending on individual factors such as age, medical history, and the presence of associated conditions. Options may include:
Lifestyle Modifications:
Adopting a heart-healthy lifestyle, including regular exercise, maintaining a healthy weight, quitting smoking, and managing other risk factors for cardiovascular disease, may help reduce the risk of complications associated with PFO.
Medications:
In some cases, anticoagulant or antiplatelet medications may be prescribed to reduce the risk of blood clots.
Percutaneous closure:
For individuals at high risk of stroke or other complications, percutaneous closure of the PFO may be recommended. This minimally invasive procedure involves inserting a closure device through a catheter to seal the opening in the heart.
Early detection and appropriate management of PFO are important for reducing the risk of associated complications such as stroke. Individuals with PFO should work closely with their healthcare providers to determine the most appropriate treatment approach based on their individual needs and risk factors.
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