Can A PFO Cause Shortness Of Breath/ Heart Murmur /Migraine /Pulmonary Hypertension Hypoxia?

Patent foramen ovale usually does not cause symptoms and can lead to a disorder of low plasma oxygen levels called hypoxemia and cause shortness of breath and fatigue1, 2.

Several studies link the association between Patent Foramen Ovale and Migraine.3

Persons with congenital heart disease may present with dyspnea on exertion, however certain symptoms such as heart murmur and hypertension can be delayed until adolescence.4

Can A PFO Cause Shortness Of Breath?

Sometimes the hole can lead to a condition of low blood oxygen levels resulting in hypoxemia (hypoxia). Although hypoxemia and hypoxia are two different conditions the presence of hypoxemia suggests hypoxia.

Hypoxemia refers to low levels of oxygen in the blood whereas hypoxia is a state in which the supply of oxygen is insufficient for normal life functions causing rapid heartbeat feeling, shortness of breath, coughing, or wheezing resulting in damages to the heart or other organs. 1, 2

PFO And Heart Murmur & Migraine

Several studies link the association between PFO and migraine attacks particularly migraine with aura. The studies revealed that there is a higher incidence of migraine in individuals with patent foramen ovale.

Migraine is a heterogeneous primary headache disorder and the prevalence in the general population of the United States is very high.  In these studies, PFO closure was performed to prevent stroke risk or shunt related issues.  The studies showed a 50% reduction in migraine frequency and decreased headache frequency thereby improving the quality of life.

PFO doesn’t cause a heart murmur and no extra sound was heard when the blood was traversing at low pressure.3

PFO And Pulmonary Hypertension Hypoxia

There is no clinical evidence on the presence of hypoxia in healthy PFO adults. However, in people with symptoms PFO resulted from venous admixture secondary to right to left shunting because of hypoxia-induced pulmonary vasoconstriction, and RA pressure later rises.4

A congenital heart defect is one of the most common birth defects and about 9 of every 1,000 babies born in the U.S. have a congenital heart defect. Due to advancements in medical technologies and pediatric cardiac surgeries, there is an increasing number of individuals who undergo PFO repair in infancy or early childhood.

Clinical studies demonstrate that over 85% of babies with patent foramen ovale experience no signs and symptoms and survive through adulthood. A statistic shows that over 1 million adults are affected by congenital heart problems and over 20,000 patients reach adolescence.

Symptoms Of Patent Foramen Ovale

PFO is a common problem, a hole in the heart. It naturally occurs in babies still in the mother’s womb for fetal circulation. The foramen ovale helps blood circulate more rapidly in the non-existence of lung function.

Post-birth, when the baby starts to breathe the lungs begins to work and the pressure causes the hole to close on its own. However, in some cases, this will not happen naturally for months and in rare cases, it doesn’t occur at all causing minimum or no symptoms.

In the majority of the cases, PFO has no symptoms at all so individuals with PFO never realize that they have this condition because it’s usually a hidden condition that doesn’t create signs or symptoms and will not pursue the diagnosis of a PFO. However, if your healthcare provider feels you require a diagnosis, they may suggest one or more diagnostic tests such as an echocardiogram, color flow doppler, and saline contrast study.

References:

  1. Layoun, Michael E, et al. “Potential Role of Patent Foramen Ovale in Exacerbating Hypoxemia in Chronic Pulmonary Disease.” Texas Heart Institute Journal, Texas Heart® Institute, Houston, 1 June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5505397/.
  2. Barr, Jayne. “Adult Congenital Heart Disease.” Cancer Therapy Advisor, 17 Jan. 2019, www.cancertherapyadvisor.com/home/decision-support-in-medicine/hospital-medicine/adult-congenital-heart-disease/.
  3. “Platypnea.” Platypnea – an Overview | ScienceDirect Topics, www.sciencedirect.com/topics/medicine-and-dentistry/platypnea.
  4. Sommer, Robert J., et al. “Pathophysiology of Congenital Heart Disease in the Adult.” Circulation, 26 Feb. 2008, www.ahajournals.org/doi/full/10.1161/circulationaha.107.714402.

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