A PFO is a small hole between the Left and Right Atriums (upper chambers) of the heart. It’s purpose was to divert oxygenated blood from the Placenta to the Left side of the heart (avoiding the yet non functioning lungs) and the rest of the body! It’s persistence past birth is called “PFO”. It is usually of no clinical consequence. This hole persist in up to 15-20% of the general population and is technically considered “normal”.
In some patients whom experience a “cryptogenic stroke” or a stroke of unknown origin, this hole is sometimes closed in a minimally invasive manner whereby a coiled up patch device called an Amplatzer is used to cover both ends of the hole. Most patients, however, do not need any treatment other than surveillance. In some cases, the hole causes extra blood flow to the right side of heart and chambers start to enlarge. If this becomes the case, then closure would also be indicated. The most common symptoms would be difficulty breathing and lower than normal oxygen levels. Surveillance of this issue is very easy and requires an Echocardiogram, which is pictured above and is the primary way to diagnose it.
Picture 1 (below) shows the blood flow depicted by Doppler (sonic waves depicted with color) from the Left Atrium to the Right Atrium (the upper chambers of the heart, shown on the bottom because the probe is pointing up from the chest to toward the head).
Picture 1
Picture 2 (below) shows the chambers before contraction near the end of the filling phase of the heart…before the pressure is high enough to cause the flow to shift to the right.
Picture 2
