Oval Foramen

Oval Foramen . Hole in the heart that did not close as it should after birth.

Summary

[ disguise ]

• 1 What is it?
• 2 Persistence of the Foramen Ovale
• 3 Symptoms of the Foramen Ovale
• 4 Complications of persistent Foramen Ovale
• 5 Diagnosis
  • 1 Flow color Doppler
  • 2 Contrast study with saline solution (bubble study)
  • 3 Transesophageal echocardiogram
• 6 Sources

What is it?

During fetal development, there is normally a small flap-like opening (the foramen ovale) in the wall between the right and left upper chambers of the heart (atria). Normally it closes during the first year of life. When the foramen ovale does not close, it is called “patent foramen ovale.”

Persistence of the foramen ovale

Patent foramen ovale occurs in about 25 percent of the general population, but most people with the condition never realize they have it. Often, patent foramen ovale is discovered during tests to look for other problems. It’s normal to be worried when you learn that you have patent foramen ovale, but most people never need treatment for this disorder.

Symptoms of Foramen Ovale

Most people with patent foramen ovale don’t know they have it because it is usually an hidden condition with no signs or symptoms.

Complications of persistent Foramen Ovale

Generally, a patent foramen ovale does not cause complications. However, in some studies, the disorder has been found to be more common in people with certain conditions, such as unexplained strokes and migraines with aura.

In most cases, there are other reasons for these neurological diseases, so it is just a coincidence that the person also has patent foramen ovale. However, in some cases, small blood clots in the heart can move through the patent foramen ovale, travel to the brain and cause a stroke.

The possible link between patent foramen ovale and stroke or migraine is controversial, and research studies are ongoing.

In rare cases, persistent foramen ovale can prevent a significant amount of blood from passing through the lungs, resulting in low blood oxygen levels (hypoxemia).

In decompression sickness, which can occur when diving, an air clot in the blood can travel through the patent foramen ovale.

In some cases, other heart defects may occur in addition to the patent foramen ovale.

Diagnosis

A doctor trained in heart disorders (cardiologist) may order one or more of the following tests to diagnose patent foramen ovale: Echocardiogram

An echocardiogram shows the anatomy, structure and function of the heart.

A common type of echocardiogram is the transthoracic echocardiogram. In this test, sound waves directed at the heart from a wand-shaped device (transducer) that rests on the chest provide video images of the heart’s movement. Doctors can use this test to diagnose patent foramen ovale and detect other heart problems.

Variations of this procedure can be used to identify patent foramen ovale, including:

flow color doppler

When sound waves bounce off blood cells flowing through the heart, they change the pitch. These characteristic changes (Doppler signals) and computerized coloring of these signals can help the doctor examine the speed and direction of blood flow in the heart.

If you have patent foramen ovale, a flow color Doppler echocardiogram can detect blood flow between the right atrium and the left atrium.

Saline contrast study (bubble study)

Using this approach, sterile saline is shaken until small bubbles form and then injected into a vein. The bubbles move to the right side of the heart and appear on the echocardiogram.

If there is no hole between the left atrium and the right atrium, the bubbles will simply leak into the lungs. If you have patent foramen ovale, some bubbles will appear on the left side of the heart. The presence of a patent foramen ovale may be difficult to confirm with a transthoracic echocardiogram.

Transesophageal echocardiogram

Doctors may perform another type of echocardiogram called a “transesophageal echocardiogram” to see the heart and blood flow in greater detail through the heart. In this test, a small transducer attached to the tip of a tube is inserted into the tube leading from the mouth to the stomach (esophagus).

This is generally the most accurate test available for doctors to see a patent foramen ovale through ultrasound combined with color flow Doppler or a saline contrast study. Other tests

Your doctor may recommend additional tests if you are diagnosed with patent foramen ovale and have had a stroke. Your doctor may also refer you to a doctor trained in brain and nervous system disorders (neurologist).