Patent foramen ovale (PFO) is a congenital heart disease when the hole (foramen ovale) located between the right and left atria does not close completely after the baby is born. Under normal conditions, the foramen ovale will close naturally after the baby is born.
While in the womb, the lungs of the fetus are not functioning. Intake of oxygen-rich blood is obtained from the placenta and transported to the right atrium of the heart through the umbilical cord. At that time, the foramen ovale plays its role in flowing blood directly from the right atrium to the left atrium of the heart, then forwarded to the left ventricle and circulated throughout the body.
After the baby is born and oxygen begins to enter the body, the lungs will begin to function normally and the route of blood circulation in the heart will also change. Oxygen-rich blood from the lungs will enter the left atrium, so the pressure in the left atrium of the heart will increase and close the foramen ovale. If the foramen ovale does not close it will cause a condition called PFO and the mixing of oxygen-rich blood with oxygen-poor blood.
Causes and Symptoms of Patent Foramen Ovale
Reason patent foramen ovale not known for sure. However, genetic factors are thought to be the main cause of patent foramen ovale on a baby.
Patent foramen ovale can cause no symptoms, so many patients are unaware that they have PFO. Most patients only realize that they have PFO when they are tested for other diseases.
In some cases, babies with PFO may show signs, such as the skin turning blue (cyanosis) when crying or defecating.
Diagnosis of patent foramen ovale
As an initial step in the diagnosis of PFO, the doctor will conduct a medical history examination by asking questions related to the symptoms experienced by the patient. Next, the doctor will recommend the patient to undergo a heart test to check the condition of the heart, namely by echocardiography or ultrasound of the heart.
Echocardiography is an examination of the heart that uses sound waves to produce a detailed picture of the condition of the heart, especially the auricles of the heart. Echocardiography can be performed through the chest wall (transthoracic echocardiogram) or insert an ultrasound device into the esophagus with the aid of an endoscope (transesophageal echocardiogram). Echocardiography through the esophagus is generally done if the chest echocardiography is not able to capture a clear picture of the heart condition.
Patent Foramen Ovale Treatment
Most of the patent foramen ovale does not require special medical treatment. The drug is only given to patients with PFO who are accompanied by stroke and heart disease. Your doctor will give you blood thinners to prevent blood clots in your heart, such as clopidogrel or warfarin.
If PFO causes symptoms to low oxygen levels in the blood (hypoxia), the doctor will advise the patient to undergo a hole or foramen ovale closure. There are 2 methods that doctors can use to close the PFO hole, namely:
- Cardiac catheterization. This procedure is performed by placing a cap on the end of a catheter that is inserted through a vein in the groin and directed directly to the heart.
- Heart surgery. The doctor will make an incision in the chest area to open access to the heart, then suture the valve opening. Heart surgery is usually done in conjunction with other procedures to correct heart problems, such as surgery bypass heart or heart valve surgery.
Complications of Patent Foramen Ovale
Patent foramen ovale generally do not cause complications, unless accompanied by other conditions, such as the formation of blood clots that can trigger a stroke.
Not closing the foramen ovale also causes PFO sufferers to be susceptible to other heart disorders, such as heart valve disease and coronary heart disease. Blood circulation disorders are also susceptible to PFO sufferers. This disorder causes an amount of oxygen-poor blood to mix with oxygen-rich blood, thereby increasing the risk of oxygen deprivation (hypoxia).
Research is still being carried out to date to ascertain the association between PFO and other diseases.
