Patent foramen ovale pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ifeoma Odukwe, M.D. [2], Priyamvada Singh, M.B.B.S. [3], Kristin Feeney, B.S. [4]

Overview

During the 4th week of gestation, formation of the atrial septum begins. Formation of the septum primum and septum secundum leads to the development of a foramen ovale which allows blood to flow from the right atrium to the left atrium in the fetus. Fusion of both septa's occurs after birth with increased left atrial pressure. The foramen ovale remains patent in some people due to failure of fusion of the septum primum and septum secundum. This permits blood flow from the right atrium to the left atrium during periods of increased right atrial pressure. Some conditions associated with patent foramen ovale include cryptogenic stroke, migraine with aura, and decompression sickness in divers.

Pathophysiology

Embryology

Physiology

Pathogenesis

Genetics

Associated Conditions

Conditions associated with patent foramen ovale include:[6][7][8]

References

  1. Kloesel B, DiNardo JA, Body SC (2016). "Cardiac Embryology and Molecular Mechanisms of Congenital Heart Disease: A Primer for Anesthesiologists". Anesth Analg. 123 (3): 551–69. doi:10.1213/ANE.0000000000001451. PMC 4996372. PMID 27541719.
  2. 2.0 2.1 Hara, Hidehiko; Virmani, Renu; Ladich, Elena; Mackey-Bojack, Shannon; Titus, Jack; Reisman, Mark; Gray, William; Nakamura, Masato; Mooney, Michael; Poulose, Anil; Schwartz, Robert S. (2005). "Patent Foramen Ovale: Current Pathology, Pathophysiology, and Clinical Status". Journal of the American College of Cardiology. 46 (9): 1768–1776. doi:10.1016/j.jacc.2005.08.038. ISSN 0735-1097.
  3. 3.0 3.1 Giblett JP, Abdul-Samad O, Shapiro LM, Rana BS, Calvert PA (2019). "Patent Foramen Ovale Closure in 2019". Interv Cardiol. 14 (1): 34–41. doi:10.15420/icr.2018.33.2. PMC 6406129. PMID 30858890.
  4. Wahl A, Windecker S, Meier B (2001). "Patent foramen ovale: pathophysiology and therapeutic options in symptomatic patients". Minerva Cardioangiol. 49 (6): 403–11. PMID 11733736.
  5. Lantz M, Sjöstrand C, Kostulas K (2013). "Ischemic stroke and patent foramen ovale: risk factors and genetic profile". J Stroke Cerebrovasc Dis. 22 (6): 841–5. doi:10.1016/j.jstrokecerebrovasdis.2012.06.002. PMID 22784820.
  6. Yakhkind, A.; Castaldo, J.; Leary, M.C. (2017). "Stroke and Migraine": 570–573. doi:10.1016/B978-0-12-803058-5.00111-9.
  7. Kerut EK, Norfleet WT, Plotnick GD, Giles TD (2001). "Patent foramen ovale: a review of associated conditions and the impact of physiological size". J Am Coll Cardiol. 38 (3): 613–23. doi:10.1016/s0735-1097(01)01427-9. PMID 11527606.
  8. Gafoor, Sameer; Sharma, Rahul; Zhang, Ming; Casterella, Peter; Atianzar, Kimberly (2017). "Update on the Management of Patent Foramen Ovale in 2017: Indication for Closure and Literature Review". US Cardiology Review. 11 (2): 75. doi:10.15420/usc.2017:18:1. ISSN 1758-3896.


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