Patent Foramen Ovale

A patent foramen ovale (PFO) is a very small hole in the atrial septum, the upper wall of the heart separating the right and left atria. A PFO is present in everyone before birth.  It functions to allow blood without oxygen (“blue” blood) to bypass the lungs such that it can leave the heart and pass to the placenta where it receives oxygen.  In most individuals, a PFO closes spontaneously during the first 1-2 years of life.  However, in 10-15% of completely normal, healthy individuals, the PFO never completely closes.  In children and teenagers a PFO is considered a completely normal variant.  Rarely in elderly individuals it may allow for a small blood clot to pass from one side of the heart to the other resulting in a stroke.  Despite this risk, there are no recommendations in older patients to close a PFO prophylactically.  Given that a PFO in a young person is a normal variant, no special restrictions or precautions are needed.  In general, no regular cardiology follow-up is needed either.