II. Epidemiology

  1. Prevalence: 25%

III. Pathophysiology

  1. Incomplete closure of the atrial septum
    1. Septum primum and secundum fail to fuse
    2. Creates a flap opening in the atrial septal wall
  2. Persistent path between atrial chamber into adulthood

IV. Associated findings

  1. Patent Foramen Ovale Aneurysm (uncommon)
  2. Fenestrations

V. Management

  1. No management needed for most patients
  2. Indications for Patent Foramen Surgical Closure in Cryptogenic Stroke (Idiopathic CVA)
    1. Large PFO
    2. PFO associated with atrial septal aneurysm
    3. Recurrent cryptogenic stroke
    4. Mas (2017) N Engl J Med 377:1011-21 [PubMed]
    5. Saver (2017) N Engl J Med 377:1022-32 [PubMed]
    6. Søndergaard (2017) N Engl J Med 377:1033-42 [PubMed]
  3. Other management in cryptogenic stroke (e.g. single CVA with small PFO)
    1. See Prevention of Ischemic Stroke
    2. Antiplatelet agents

VI. Complications

  1. Consider as benign incidental finding in most patients
  2. Cryptogenic Stroke (CVA without definitive cause)
    1. Prospective trials do not show increased CVA risk
    2. However, large PFO or PFO associated with atrial septal aneurysm may

VII. References

  1. Nelson (2007) MP Primary Care Medicine, Lecture

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Foramen Ovale, Patent (C0016522)

Definition (MSH) A condition in which the FORAMEN OVALE in the ATRIAL SEPTUM fails to close shortly after birth. This results in abnormal communications between the two upper chambers of the heart. An isolated patent ovale foramen without other structural heart defects is usually of no hemodynamic significance.
Concepts Congenital Abnormality (T019) , Disease or Syndrome (T047)
MSH D054092 , D006344
ICD10 Q21.1
SnomedCT 268316001, 156912004, 204317008, 78902000
English FORAMEN OVALE PATENT, Patent Oval Foramen, Oval Foramen, Patent, Patent Foramen Ovale, foramen ovale patent, patent foramen ovale, patent foramen ovale (diagnosis), Patent or persistent foramen ovale, Foramen Ovale, Patent [Disease/Finding], Foramen Ovale, Patent, patent foraman ovale, secundum atrial septal defect, patent foramen ovales, Patent foramen ovale, PFO - Patent foramen ovale, Patent foramen ovale (disorder), foramen; ovale, open, nonclosure; foramen ovale, open; foramen ovale, ovale; foramen, nonclosure, Fossa ovalis defect, Foramen ovale patent
Dutch geopend foramen ovale, foramen; ovale, open, niet sluiten; foramen ovale, open; foramen ovale, ovale; foramen niet gesloten, Open foramen ovale
French Perméabilité du foramen ovale, PFO (Persistance du Foramen Ovale), FOP (Foramen Ovale Perméable), Persistance du foramen ovale, Foramen ovale perméable, PERSISTANCE DU TROU OVALE
German Foramen ovale durchgaengig, Foramen ovale apertum, Foramen ovale, offenes, FORAMEN OVALE OFFEN
Portuguese Persistência do foramen ovale, Forame Oval Patente, PERSISTENCIA DO FORAMEN OVAL
Spanish Foramen oval persistente, Agujero Oval Permeable, Foramen Oval Permeable, FORAMEN OVAL PERSISTENTE, defecto de la fosa oval, foramen oval permeable, foramen oval persistente (trastorno), foramen oval persistente
Japanese ランエンコウカイゾン, 卵円孔開存, 開存-卵円孔
Finnish Avoin soikea aukko
Italian Forame ovale pervio
Swedish Öppetstående foramen ovale
Czech Otevřené foramen ovale, foramen ovale patens, foramen ovale pervium, foramen ovale persistens, foramen ovale apertum, patent foramen ovale
Polish Otwór owalny przetrwały, Drożny otwór owalny, Przetrwały otwór owalny, Otwór owalny drożny
Hungarian Foramen ovale nyitott
Norwegian Åpentstående foramen ovale, Persisterende foramen ovale, Patent foramen ovale