What Is a Patent Foramen Ovale?

A patent foramen ovale, or PFO, is a small opening between the upper chambers of the heart. This opening is normal before birth and usually closes naturally shortly after a baby is born.

A PFO develops when the small opening between the atria does not close after birth. Healthcare providers do not fully understand why this happens in some people.

In some people, the opening does not fully close. Most people with a PFO never know they have it, but in certain situations it can increase the risk of blood clots traveling to the brain and causing a stroke.

Symptoms

Most people with a PFO do not have symptoms. The condition is often found during testing for another health issue.

When complications occur, symptoms are usually related to stroke or reduced blood flow to the brain. Symptoms may include:

• Sudden weakness or numbness
• Trouble speaking
• Vision changes
• Severe headache
• Dizziness
• Loss of coordination or balance

How Is It Diagnosed?

A healthcare provider may suspect a PFO after an unexplained stroke or during heart testing for another condition.

Tests used to diagnose a PFO may include:

• Echocardiogram
• Bubble study
• Transesophageal echocardiogram
• Cardiac CT or MRI
• Transcranial Doppler ultrasound

These tests help providers evaluate blood flow through the heart and look for abnormal openings.

How Is It Treated?

Many people with a PFO do not need treatment. Care depends on whether the condition has caused symptoms or complications such as stroke.

Treatment options may include:

• Antiplatelet medications
• Blood-thinning medicines
• Catheter-based closure procedures
• Surgical repair in selected cases

Your healthcare provider may also recommend lifestyle changes to reduce stroke risk, including staying active, managing blood pressure, avoiding smoking, and treating other heart conditions.