• PFO stands for “patent foramen ovale.” It is a small hole between the heart’s two upper chambers, called the right and left atria. Before you can understand PFO, you need to know how the heart normally works and is structured. The heart has four chambers: two in the top (atria) and two in the bottom (ventricles). One wall of tissue, called the septum, separates the right and left sides of the heart. People with a PFO, on the other hand, have a small hole in this wall that stays there after birth.

• During fetal development, this opening, known as the foramen ovale, is a normal and necessary part of circulation. It allows blood to bypass the lungs, which are not yet functional in utero. Normally, the foramen ovale closes shortly after birth when the newborn begins to breathe and the lungs start functioning. In about 25% of the population, however, this opening fails to close completely, resulting in a PFO.

• PFO is relatively common, affecting approximately one in four adults. It’s not considered a congenital heart defect, but rather a normal variant in heart anatomy. There are no known risk factors for developing a PFO, as it’s determined before birth. However, certain conditions, such as the Valsalva maneuver (straining) or specific genetic factors, may increase the likelihood of complications in individuals with PFO.

• Most people with a PFO experience no symptoms and may never know they have this condition. PFO is often discovered incidentally during tests for other heart conditions. In some cases, it may be associated with migraines with aura or certain types of strokes, particularly cryptogenic strokes (strokes with no apparent cause). Diagnosis typically involves echocardiography, particularly transesophageal echocardiography (TEE), which provides detailed images of the heart’s structure. A bubble study, where saline solution is injected into a vein and tracked through the heart, can also help detect a PFO.

The majority of people with PFO require no treatment. For those who have had a stroke believed to be related to PFO, treatment options may include:

• Antiplatelet therapy or anticoagulation to reduce the risk of blood clots.
• PFO closure; a minimally invasive procedure where a device is inserted to close the opening.

The decision to close a PFO is made on a case-by-case basis, considering factors such as age, the risk of recurrent stroke, and the presence of other cardiovascular risk factors.

For most individuals, having a PFO does not impact daily life or require lifestyle changes. However, those with a known PFO should discuss any concerns with their healthcare provider, particularly regarding activities like scuba diving. Regular follow-ups may be recommended, especially if there are associated conditions or if closure has been performed.

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You can review our cardiologists’ pages and explore their exceptional credentials and dedication to providing quality care. You can trust that our doctors genuinely care about you and will do everything they can to ensure you have the best quality of life possible.

To learn more, please call (770) 962-0399 or 678-582-8586. You may also request an appointment online. If you have an emergency, don’t contact us online; please call 911.