Clinical significance of patent foramen ovale

A patent foramen ovale is a connection between the right and left atria that persists after birth. The foramen ovale is found in fetal anatomy normally and closed after birth but can remain open for life resulting in patent foramen ovale. Patent foramen ovale is an embryological remnant of the fetal circulation. Oxygenated placental blood enters the right atrium via the inferior vena cava and crosses the valve of the foramen ovale to enter the systemic arterial system. The inferior vena cava flow preferentially flows toward the inter atrial septum and foramen ovale. At birth, pulmonary vascular resistance and right-sided cardiac pressures drop with a reversal of the right atrium -to-left atrium pressure gradient. The flap of the foramen ovale closes against the atrial septum with fusion usually occurring within the first two years of life. Fusion is incomplete in about 25% of people, resulting in an oblique slit-like defect. Though patent foramen ovale is usually considered non threatening but it can be associated with cerebral ischemic events such as stroke and migraine. A patient can undergo for an ultrasonography to identify patent foramen ovale. When a patent foramen ovale is detected, the patient can receive surgical placement of a closure device.