Patent Foramen Ovale


The foramen ovale is an opening in the upper chambers of the heart. Before a baby is born, the foramen ovale allows blood flow to bypass the lungs. A baby receives its oxygen from the placenta and does not need to use the lungs. After birth, blood flow must reach the lungs and the foramen ovale is no longer needed. It will usually close within the first few months after an infant is born.

For many individuals, this opening does not close — which is called patent foramen ovale (PFO). This is common, and 1 in 4 people have this condition. Adults may not recognize they have PFO, and many live a healthy, normal life while experiencing no complications.


Most individuals with this condition are asymptomatic, which means they do not experience any symptoms. In some cases, adults with a PFO will experience migraines.


This condition cannot be prevented. There is no known reason for why the foramen ovale does not close for some infants.

Risk Factors

There are no risk factors for patent foramen ovale. However, many patients who have the condition may also have another congenital heart defect.


Patent foramen ovale can be difficult to diagnose. A small number of patients with the condition may experience a stroke because the opening allows blood clots to travel to the brain. In this case, your healthcare provider may order an echocardiogram to see if you have the condition.

An echocardiogram test uses sound waves to generate pictures of the heart. Your healthcare provider will look closely at the heart for any abnormalities. During the test, your provider may also inject a saline solution into a vein. If patent foramen ovale is present, tiny air bubbles will show on the monitor moving from the right to left side of the heart.


This condition usually requires no treatment. But if you have other heart problems or experienced a stroke caused by a blood clot in the brain, your healthcare provider may recommend treating the condition with the following:

  • Drug treatment. Your physician may prescribe a medication to prevent further blood clots. Medications will not seal the hole, but they may reduce your risk of stroke.
  • Surgery. To surgically close the hole, a cardiologist will perform either open-heart surgery (only if another cardiac surgery is being performed at the same time) or cardiac catheterization — a less invasive procedure that uses a catheter-closure device. Your healthcare provider will decide with you whether or not to close the hole depending on your own circumstances.

Follow-up Care

After surgery, your physician may continue to monitor for any complications. Ask your provider for specific instructions for care following surgery.


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