Is Patent Foramen Ovale A Serious Condition & Can It Be Reversed?

If you have no risk nor having a history of traveling blood clots, your condition is not serious and doesn’t require treatment.1

Patent foramen ovale in some patients may lead to complications and one of the most critical health problems is transient ischemic stroke and heart attack.2

Patent foramen ovale can be reversed by the administration of positive inotropic medications such as aspirin and warfarin, nitric oxide, or both.3, 4

Is Patent Foramen Ovale A Serious Condition?

Patent foramen ovale is generally asymptomatic and symptoms are not visible. Most cases of PFO are not even diagnosed until patients undergo medical examinations for other heart conditions such as a transient ischemic attack, stroke, heart attack, or migraine with aura.

Among the different complications, stroke is most devastating which often results in swallowing difficulties, pain, and sensory problems, problems with speaking, reading, writing, and understanding, extreme tiredness, and fatigue. The risk of stroke is higher as the patients begin to age.

Medical studies have demonstrated that this is especially true in patients over 60 years.1

Other risk factors include high blood pressure, the habit of alcohol & smoking, elevated levels of cholesterol & sugar levels, and a family history of cardiovascular diseases. Furthermore, cardiac diseases such as atrial fibrillation can also cause stroke and these disorders are treated through blood thinners like aspirin and warfarin to help prevent blood clots. Damages in the arteries and bleeding from the damaged arteries may induce a stroke.

Individuals get treatment for a Patent foramen ovale, particularly if they have had a stroke due to the foramen ovale. Treatment depends on the size of the hole and the complication involved. However, the most common form of treatment is through medicines. Conditions that do not respond to medications are treated through procedures and surgery.2

Can Patent Foramen Ovale Be Reversed?

Patent foramen ovale closures are generally simple and safe when performed by experienced and professional cardiologists. Serious complications are exceedingly rare and can be attributed to design flaws in the cardiac catheter device. Therefore, clinical studies suggest the appropriate use of fluoroscopy and echocardiography to lessen the risks.

Periprocedural complications are more common than late complications however they are generally benign and reversible. Rarely hypoxaemic patent foramen ovale is associated with shunt reversal at the atrial level. However, the only choice of closure for this complication through interventional catheterization. The reversal of PFO can be accomplished by the administration of positive inotropic medications.

A study was conducted on 21 patients who underwent PFO closure using the Amplatzer device. Out of these 21 patients, 19 had PFO with minimal symptoms and two had a tiny residual shunt. The oxygen saturation and pressure varied significantly in these patients but still, seventeen patients showed improvement. However, there were three deaths in patients with chronic respiratory infections. The studies concluded that right-left interauricular shunts can be successfully treated by catheterization.3, 4

Having a PFO does not mean you will necessarily have complications and negative side effects. Patent foramen ovale in most patients is asymptomatic meaning it doesn’t produce any signs and symptoms. During many instances, individuals never even find out that they have one.

Patients having this condition can still lead to a normal routine and will never face problems concerning PFO. Most conditions of PFO are diagnosed after a stroke or cardiac arrest through echocardiography or a transcranial doppler test. PFO can never be found under physical examination however your healthcare provider may suggest diagnostic tests when the heart murmur is high than usual.

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/symptoms-causes/syc-20353487.
  2. “Patent Foramen Ovale (PFO)- About Congenital Heart Defects.” Www.heart.org, www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/patent-foramen-ovale-pfo.
  3. Mehan, V. K., et al. “Use of the Reversed Button Device to Treat an Atrial Septal Aneurysm Associated with a Patent Foramen Ovale.” Heart, BMJ Publishing Group Ltd, 1 Nov. 1995, heart.bmj.com/content/74/5/563.
  4. Falanga, Gabriella, et al. “How to Understand Patent Foramen Ovale Clinical Significance: Part I.” Journal of Cardiovascular Echography, Medknow Publications & Media Pvt Ltd, 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC5353567/.

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