Patent foramen ovale natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [3]
Overview
The presence of a patent foramen ovale has been linked to decompression sickness, paradoxical embolism and migraine. There is a debate within the neurology and cardiology communities about the role of a patent foramen ovale in cryptogenic stroke. The prognosis of uncomplicated patent foramen ovale is generally good.
Natural History, Complications, and Prognosis
Natural History
Complications
- Common complications of patent foramen ovale include:[1][2][3]
- Paradoxical embolism (from a venous thrombi leading to cerebral or peripheral stroke)
- Hypoxemia
- Severe decompression sickness (due to paradoxical gas embolism)
Prognosis
- The prognosis of patent foramen ovale depends on the size of defect, amount of shunting and presence of any associated defects.
- Overall, the prognosis of patients with patent foramen ovale is good.
- Some infants presenting with cyanosis due to right-to-left shunting, might have complete resolution as they grow up (due to decrease in pulmonary vascular resistance).
- Patent foramen ovale associated with other congenital heart defects like Ebstein's anomaly might continue to have problems due to right-to-left shunting.
- Also, some patients with cryptogenic stroke might continue to have transient ischemic attacks and stroke due to continued right-to-left shunting.
- An incidentally discovered, asymptomatic patent foramen ovale, doesn't require any special treatment or follow-up.
References
- ↑ Homma S, Messé SR, Rundek T, Sun YP, Franke J, Davidson K; et al. (2016). "Patent foramen ovale". Nat Rev Dis Primers. 2: 15086. doi:10.1038/nrdp.2015.86. PMID 27188965.
- ↑ Tobis JM, Narasimha D, Abudayyeh I (2017). "Patent Foramen Ovale Closure for Hypoxemia". Interv Cardiol Clin. 6 (4): 547–554. doi:10.1016/j.iccl.2017.05.003. PMID 28886845.
- ↑ Kolte, Dhaval; Inglessis, Ignacio; Elmariah, Sammy (2020). "Peripheral Embolism and PFO": 109–113. doi:10.1016/B978-0-12-816966-7.00009-9.