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.

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

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