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Patent Foramen Ovale (PFO)

The patent foramen ovale (PFO) is a small hole located in the septum – the wall between the two upper chambers of the heart.

While in the womb, a fetus does not use its lungs to get oxygen-rich blood. Instead, blood comes from the mother’s placenta and is delivered through the umbilical cord. The foramen ovale makes it possible for the blood to go from the right side of the fetus’ heart to the left side of the heart.

The foramen ovale normally closes after birth.

A patent foramen ovale (PFO) means it did not close at birth. In many cases, the PFO does not stay open at all times. Instead, it’s more like a flap that opens when there is higher pressure than normal such as during bowel movements, or when coughing and sneezing.

Signs & Symptoms

Most adults with a PFO do not have symptoms. However, the condition has been linked to migraine headaches and it increases the risk of:

  • Stroke
  • Transient ischemic attack
  • Heart attack


Specialized testing is needed to detect a PFO. An adult congenital heart specialist at Deborah Specialty Physicians may order the following tests:

  • Echocardiogram
  • Transesophageal echo
  • Bubble study

Other tests to check your heart rhythm, nervous system, and to test for conditions that increase the risk of blood clots may also be needed.