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    Patent foramen ovale

    PFO

    Patent foramen ovale (PFO) is a hole between the left and right atria (upper chambers) of the heart that fails to close naturally soon aftera baby is born.

    Causes

    A foramen ovale allows blood togo aroundthe lungs. A baby's lungs are not used when it grows in the womb, so the hole does not cause problems in an unborn infant.

    The opening is supposed to close soon after birth, but sometimes it does not. In about 1 out of 4 people, the opening never closes. If it does not close, it is called a patent foramen ovale (PFO).

    The cause of a PFO is unknown. There are no known risk factors.

    Symptoms

    Infants with a patent foramen ovale and no other heart defects do not have symptoms.

    Exams and Tests

    An echocardiogram can be done to diagnose a PFO. If the PFO is not easily seen, a cardiologist can perform a "bubble test." Saline solution (salt water) is injected into the body as the cardiologist watches the heart on an ultrasound (echocardiogram) monitor. If a PFO exists, tiny air bubbles will be seen moving from the right to left side of the heart.

    Treatment

    This condition is not treated unless there are other heart problems, or the person had a stroke caused by a blood clot to the brain.

    Treatment usually requires a procedure called cardiac cathertization, which is performedby a trained cardiologist to permanently seal the PFO.

    Outlook (Prognosis)

    An infant who has no other heart defects will have normal health.

    Possible Complications

    Unless there are other defects, there are usually no complications froma PFO.

    Olderpeople with PFOs may have a higher rate of a certain type of stroke (called paradoxical thromboembolic stroke), because they oftendevelop blood clots in their legveins. These clots can sometimes travel to the right side of the heart. The clot can pass from the right side to the left side of the heart. It may travel to the brain and becomestuck there, preventing blood flow to that part of the brain (stroke).

    Some patients may take medication to prevent blood clots.

    When to Contact a Medical Professional

    Call your health care provider if your baby turns blue when crying or having a bowel movement. Usually, this disorder is only discovered when a cardiologist performs an echocardiogram (ultrasound of the heart) for an unrelatedheart murmur.

    References

    Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 65.

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      A Closer Look

        Review Date: 12/1/2011

        Reviewed By: Kurt R. Schumacher, MD, Pediatric Cardiology, University of Michigan Congenital Heart Center, Ann Arbor, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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        St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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