You might be surprised to learn you were born with a heart condition as an adult. Some people find out they have a patent foramen ovale (PFO) after testing for migraines, a stroke or other health issues. A PFO is common and usually doesn’t cause symptoms, so it can go unnoticed for years.
At Banner Health, our heart specialists use advanced imaging and minimally invasive treatments to create a care plan just for you. Learning you have a heart condition can feel unexpected but you don’t have to navigate it alone.
A patent foramen ovale is a small flap-like opening between the two upper chambers of the heart. Everyone has this opening before birth. It helps blood flow through the heart as a baby grows in the womb (uterus). Usually, it closes before a child turns 3.
“Patent” means open, and “foramen ovale” is the small flap. When it stays open after age 3, it is called a patent foramen ovale.
A PFO is considered a congenital heart condition because people are born with it. But unlike many heart defects you are born with, a PFO is often mild and may not be discovered until adulthood.
PFO is common. About one in four adults have it. Most people don’t know they have it until later in life. Some find out during a routine test, while others discover it after a health problem sends them to a health care specialist.
Before a baby is born, it doesn't use its lungs to breathe. Instead, oxygen goes through the placenta. Because of this, blood flows differently through the baby's heart while developing.
The foramen ovale is an opening between the right and left upper chambers of the heart. This opening allows blood to skip the lungs before birth. After birth, the lungs start working and changes in pressure usually close this opening.
If the foramen ovale does not close after birth, it is called a PFO. It can go unnoticed for many years, but it is a type of heart condition that people are born with.
A patent foramen ovale is not caused by anything you did or didn’t do. It doesn’t come from your diet, habits or how much you exercise.
Experts don’t fully understand why the opening stays partly open in some people. But genetics might play a small role.
PFO is common and can happen in healthy people. Most adults with a PFO go for years without any symptoms or problems.
Most people with a PFO show no symptoms. When symptoms appear, they usually come from another condition linked to the foramen ovale, not the opening itself.
Some people learn they have a PFO after:
Normally, the heart pumps blood into the lungs. The lungs filter out small clots before the blood leaves. When you have a PFO, some blood can bypass this filter by slipping through the open flap. If a clot passes through, it can travel to the brain and block a blood vessel. This is called a PFO-associated stroke.
Not everyone with a PFO will have a stroke. The risk remains low for most people. But if you have had one tied to a PFO, your care team will help you lower the chance of another incident.
Learn about different stroke types.
Because a PFO often doesn’t cause symptoms, health care providers usually find it while testing for other problems. They might suggest tests if you've had an unexplained stroke, migraines or other symptoms that could be linked to a PFO.
Tests may include:
Not everyone with a PFO needs treatment. Your provider might just watch the condition if you have no symptoms or other health problems.
Treatment may be recommended if:
Your care team will discuss the benefits and risks of treatment with you, based on your personal health history and goals.
Treatment depends on your symptoms, age and risk factors. It might include:
Some people take medications to help lower the risk of blood clots. This might be enough for those who do not need a medical procedure. These medicines may include:
Some adults can get help by closing the opening. A PFO closure is usually a minimally invasive procedure. A cardiologist guides a thin tube called a catheter through a blood vessel (often in the groin) to the heart. They place a small device to seal the opening. Over time, heart tissue grows around the device.
Most people go home the same day or the next day. The recovery is faster than open-heart surgery because the chest doesn’t need to be opened.
After the procedure, you might feel mild soreness or bruising where the catheter was inserted. Your care team will give you instructions on activity limits and medications to help you heal. Your doctor may ask you to avoid heavy lifting or intense exercise for a short time.
If a PFO closure isn’t possible, your doctor might suggest minimally invasive heart surgery or open-heart surgery.
Most people with a patent foramen ovale live full, active lives. They continue working, exercising, traveling and spending time with family just like before.
Some people never need treatment. Others feel more at ease after learning the cause of their symptoms or completing treatment.
A few helpful steps can support your long-term health:
If you plan to scuba dive or take a long flight soon, ask your provider for guidance. In rare cases, a PFO can increase the risk of decompression sickness or blood clots from sitting too long.
Talk with your health care provider if you:
At Banner Health, we are experts in diagnosing and treating patent foramen ovale and other heart conditions. Here’s why patients choose us:
If you have been told you have a PFO or had a stroke without a clear cause, our team can help you understand your choices. Book an appointment today.
No. Usually, a PFO is not dangerous and causes no symptoms. But in rare cases, it can allow blood clots to bypass the lungs and travel to the brain, increasing the risk of stroke.
No. Once you reach adulthood, the flap will not close on its own. The good news is that most PFOs do not require closure.
Most people with a patent foramen ovale never need surgery. A PFO needs closure only if you have had an unexplained stroke, a TIA or other complications.
A PFO is strongly associated with migraine with aura, migraine aura without headache and chronic migraine.
A PFO is a small flap-like opening in the heart that doesn’t fully close after birth. An atrial septal defect (ASD) is a true hole in the wall between the upper chambers of the heart. ASDs are usually bigger and can affect blood flow. Some ASDs need treatment early in life but many do not. PFOs usually don’t cause any symptoms.
Most people with a PFO can exercise safely. Ask your provider if you have a history of stroke, low oxygen levels or other heart concerns.
A PFO begins before birth. Most babies' openings close naturally after they are born. Some people have a PFO into adulthood without realizing it.
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