Patent Foramen Ovale (PFO)

Most people with PFO don’t have any symptoms and may be unaware that they have the condition. 

Rarely, if the opening between your heart chambers is big enough for a lot of blood to pass between them, it can cause symptoms such as: 

• severe headaches or migraines 

• orthodeoxya-platypnoea syndrome – shortness of breath when standing up

• low blood oxygen levels (hypoxia) – symptoms may include shortness of breath, rapid heart rate, headache, a bluish tinge to the skin, fingernails and lips (cyanosis) 

• unexplained strokes or transient ischaemic attacks (TIAs) – symptoms may include sudden weakness on one side of your body, numbness, dizziness, difficulty speaking and visual problems

The cause of PFO is unknown, but it may be genetic or linked to other congenital heart problems. PFO is normally diagnosed during a routine test, such as an echocardiogram, or during tests or treatments for other conditions, such as strokes of unknown cause or decompression sickness (the bends).

At your initial consultation, you’ll be seen by a consultant cardiologist, a doctor with specialist training in diagnosing and treating heart conditions. Your cardiologist will ask you about your symptoms, general health and medical history. They may perform a physical examination, including listening to your heart with a stethoscope. If PFO is suspected, your cardiologist may order some tests to confirm or rule out the diagnosis. 

Tests for PFO include: 

• bubble transthoracic echocardiogram (TTE)

• transesophageal echocardiogram (TOE)

Your consultant will make a diagnosis based on a combination of your symptoms, physical examination and the results of any tests. They will discuss your test results and diagnosis with you and create a personalised treatment plan tailored to your individual needs. 

There’s currently no way to prevent PFO as it’s a congenital condition (present at birth). However, you can reduce the risk of developing the complications associated with PFO by following the treatment plan recommended by your cardiologist.

PFO is usually a harmless condition that doesn’t need treatment. However, in rare cases, complications can occur. 

Complications of PFO may include: 

• paradoxical embolism – occurs when small blood clots pass through the opening to the left side of the heart, bypassing the lungs and travelling to the brain, where they can cause a stroke or TIA (mini-stroke). Rarely, blood clots can also lead to a heart attack or ischaemia (lack of blood supply) in other organs

• hypoxaemia/ hypoxia – rarely, if a lot of blood bypasses your lungs, it can lead to low levels of oxygen in your blood and tissues

• decompression illness – PFO can increase the risk of decompression illness or 'the bends' as it allows nitrogen bubbles to enter the bloodstream

• migraines – there may be a link between PFOs and migraines with aura

Many PFOs don’t need to be treated, but if your PFO is causing symptoms or you are experiencing complications such as a stroke, migraines or low blood oxygen levels, your cardiologist may recommend treatment. 

Treatment for PFO may include: 

• medications – blood thinners such as aspirin and warfarin may be prescribed to prevent blood clots from forming 

• catheter-based closure

At Welbeck, our cardiologists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialities, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.