How to Diagnose Patent Foramen Ovale & What Is The Best Medicine For It?

Most of the time when there are no symptoms or complications, there is no need to go in for the diagnosis of a PFO.1

When your doctor feels a diagnosis is necessary a color flow Doppler echocardiogram could detect the flow of blood in the heart.2

PFO often results in blood clots so the patients would be given antiplatelet and anticoagulant medicines to help prevent blood clots.3, 4

How to Diagnose Patent Foramen Ovale?

A small size Patent foramen ovale does not cause any symptoms so it is not a complication to be worried about. However, large-diameter PFO can become a passage of thrombus, air, fat, vegetation, or vasoactive substances. The greater number of microbubbles passing through a shunt is typically diagnosed during echocardiography when examining for other cerebrovascular events.

Although Patent foramen ovale is highly recognized to be a leading factor for cryptogenic cerebrovascular events, there can be other events as well that causes the right to left shunt. Therefore, your cardiologist may suggest one or more tests depending on the size of the hole and the symptoms involved.1

Echocardiogram – An echocardiogram provides the structure and function of the heart movements. This test uses sound waves that are directed to the heart through a transducer with varying voltages applied to the crystals. The echocardiography test assesses how well the heart works, the heart’s function, and its structures.

There are some variations made in the echocardiography to help identify the condition. This includes:

Color Flow Doppler – Also called color Doppler imaging (CDI) is a development of pulsed-wave Doppler measures and color-codes the mean within a user-defined area. The primary importance of the test is to make a quantitative assessment of blood flow.

Saline Contrast Study – This is an established imaging modality that observes the bubbles in the pericardial fluid. If there is no hole in the heart, then the bubbles will be filtered in the lungs. If there is a hole, some bubbles will be noticed on the left side of the heart.2

What is the Best Medicine for Patent Foramen Ovale?

Most conditions of Patent foramen ovale do not require treatment. When there is no history of stroke or other cardiovascular conditions, especially problems with blood clots, those patients don’t need treatment. However, when you have problems due to traveling blood clots that often leads to stroke, your health provider will suggest the below medication to treat or prevent conditions. This includes

  • Antiplatelet and anticoagulant medicines such as aspirin or warfarin to help prevent blood clots. Aspirin has better recommendations when compared to warfarin due to lesser side effects.
  • Conditions that cannot be treated through medications are handled through catheter-based cardiac surgery.
  • In some cases, Patent foramen ovale closure is performed during open-heart surgery.
  • In many cases, the cardiologist may not suggest a direct treatment instead such as lifestyle changes with enough exercises and healthy eating.3, 4

Patent foramen ovale is a complication of fetal circulation that is often associated with a transient ischemic attack (TIA), migraine headaches, decompression illness, and cryptogenic stroke. Most people with Patent foramen ovale have no symptoms so it’s most often diagnosed during an examination of some other heart complication.

In some cases, a patent foramen ovale can produce breathing difficulties when the newborn enters adulthood. Some babies with heart or lung problems may turn blue, a condition known as cyanosis when crying or passing stool. This is one of the most common symptoms when the infant has foramen ovale.

References:

  1. “Patent Foramen Ovale.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Mar. 2018, www.mayoclinic.org/diseases-conditions/patent-foramen-ovale/diagnosis-treatment/drc-20353491
  2. Pinto, F J. “When and How to Diagnose Patent Foramen Ovale.” Heart (British Cardiac Society), Copyright 2005 by Heart, Apr. 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC1768819/
  3. “Patent Foramen Ovale (PFO) Management and Treatment.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/17326-patent-foramen-ovale-pfo/management-and-treatment
  4. Sandy N Shah, DO. Patent Foramen Ovale Treatment & Management: Medical Care, Surgical Care, Complications, Medscape, 24 July 2020, emedicine.medscape.com/article/156863-treatment

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