Patent Foramen Ovale - Symptoms, Complications, and Management

Introduction:

In a normal-born baby that does not have a congenital heart disorder, the right part of the heart smoothly pumps blood that is low in oxygen to the lungs. The left part of the heart efficiently pumps blood that is rich in oxygen to the body. When a baby starts to grow inside the womb of the mother while pregnant, there is the presence of two tiny openings that are in between the left side of the heart and the right side of the heart. These two normal holes or openings during birth are referred to as the patent ductus and patent foramen ovale. After the child is born and starts breathing in the world, the two openings eventually narrow in size and, within a few days, completely get closed.

The presence of a patent foramen ovale is natural during birth. The patent foramen ovale, or the PFO, is a tiny aperture in between the two chambers of the upper sections of the heart, called the right atrium and the left atrium. Generally, a very thin membrane or a wall that is made of two flaps that are connected to each other separates the two right and left atrium chambers. Due to this separation, no amount of blood can pass or flow between the two chambers. In the presence of a patent foramen ovale, only a small amount of blood is able to flow freely between the upper right and the left atriums via the flaps. It should be noted that this amount of blood flow is not considered to be normal. This is because it increases the risk of occurrence of a stroke in the patient since a blood clot may get formed and can move between the two atriums of the heart. Such blood clots may also destroy other vital organs like the heart, the kidneys, or the liver.

What Leads to Patent Foramen Ovale?

There is no definite cause that may directly lead to the formation of patent foramen ovale. There have been several types of research, and the present conclusion is- patent foramen ovale is largely idiopathic but a few conditions, such as the Ebstein anomaly, may pose a higher risk in the development of patent foramen ovale. Patent foramen ovale is not a sole condition and is generally accompanied by the presence of several other congenital or cardiovascular diseases.

What Are the Signs and Symptoms of Patent Foramen Ovale?

A patent foramen ovale does not have specific signs and symptoms. The clinical manifestations of patent foramen ovale are parallel to the underlying cardiovascular system. The risk of stroke and episodes of brain stroke is the only notable symptoms of untreated and long-standing patent foramen ovale. Hypertension, hyperventilations, difficulty in breathing, and palpitations are a few of the other common signs and symptoms of patent foramen ovale.

How to Diagnose Patent Foramen Ovale?

The presence of a patent foramen ovale may be done during childbirth or even a few days after the baby is born. Several tests, along with a thorough understanding of the clinical signs and symptoms of the baby, medical and drug history of the mother, as well as several other series of questions and examinations, lead to the final diagnosis of the presence of patent foramen ovale.

Mentioned below are some of the diagnostic tools that aid in the determination of patent foramen ovale.

• Transthoracic echocardiography.

• Transesophageal echocardiography.

• Ultrasound of the heart.

• Multidetector computed tomography.

• Magnetic resonance imaging of the heart.

• Complete blood picture.

• Bubble study.

• Chest x-rays.

How to Treat Patent Foramen Ovale?

The majority of the cases of patent foramen ovale do not require any specific kind of treatment. In case the clinical signs and symptoms are severe, treatment is provided accordingly.

Mentioned below are a few of the treatment modalities of patent foramen ovale.

• Antiplatelet medications.

• Anticoagulant medications.

• Surgical procedure via catheter to close the patent foramen ovale.

• Heart surgery.

Are There Any Complications of Patent Foramen Ovale?

In case patent foramen ovale is not diagnosed at the right time, and is not treated accordingly, certain complications may develop in the patients suffering from patent foramen ovale.

Mentioned below are a few of the complications of patent foramen ovale.

• Numbness.

• Leg weakness.

• Mental confusion.

• Abnormal vision.

• Episodes of headache.

• Unbalanced coordinations.

• Stroke.

• Migraine.

• Cluster headaches.

• Vascular disturbances.

• Myocardial infarctions.

• Blood clots.

• Air emboli.

• Adipose tissue clot.

Can Patent Foramen Ovale Be Managed?

A patient can live with a patent foramen ovale in case a management plan is laid down by the doctor and the patient follows the same religiously. A diet rich in green leafy fruits and vegetables, low sodium, and a high amount of lean protein must be added regularly. Maintaining the body mass index accordingly is crucial as well. Patients who are suffering from underlying cardiovascular diseases such as atrial fibrillation must take the necessary treatment and must follow all the instructions provided by the health care provider and team.

Conclusion:

Patent foramen ovale or PFO is a congenital abnormality of the heart wherein one of the two naturally occurring holes or apertures of the heart remain open and do not completely close at the desired time. This condition does not cause severe changes in the cardiovascular system but at times, may lead to certain complications such as stroke, migraine, cluster headaches, and blood clots. Management of patent foramen ovale is done by following a healthy diet along with regular physical activity and avoiding an obese lifestyle. Medications such as anticoagulants and hypertensives must be strictly taken as per the doctor’s recommendation. Patients are suggested to avoid smoking and totally restrict the habit of drinking alcohol.