Can you live with a hole in your heart?

It is very possible to live with a hole in your heart, without ever realising that it’s there. A patent foramen ovale, also known as a PFO, is a hole between the left and right atria (upper chambers) of the heart that we all have when we are in the womb, but this should close shortly after we’re born. It remains open, however, in around 20% of people, the majority of whom are oblivious to this hole.

Cardiologist Dr Mark Mason talks more about patent foramen ovale and when it requires treatment.

Can a PFO cause health problems or complications?

In the majority of patients, a PFO has absolutely no consequences and most people will never know that they have one. In very few patients, we believe it can sometimes be responsible for a mini-stroke, otherwise known as a transient ischaemic attack (TIA) when there is no other reason as to why the patient should experience such an event. A mini-stroke occurs when blood flow to the brain stops for a short period of time, but brain tissue damage does not occur.

Is it possible to live problem-free with a hole in your heart?

Yes, the majority of people with a PFO will never know that they have it and it will cause no problems or complications for the patient as they go about their day to day lives.

When does a PFO require treatment? Will surgery be required?

A PFO only requires treatment or surgery in a patient who has had a TIA or stroke and has a PFO which has certain high-risk features. A high-risk PFO can be diagnosed by a particular type of specialised ultrasound scan of the heart called a bubble contrast echocardiogram. A sterile salt solution is shaken until tiny bubbles are formed and this is then injected into a vein. The bubbles travel to the right side of the heart and appear on the echocardiogram. If there is no hole between the right and left sides of the heart, the bubbles will move into the lungs, however, if a patent foramen ovale is present, some bubbles will show up on the left side of the heart.

Another type of echocardiogram called a transoesophageal echocardiogram might be used to get a closer look at the heart, whereby an ultrasound tube is inserted, going from the mouth to the stomach to look at blood flow through the heart.

Surgery can be done as a day case procedure by inserting a special closure device into the heart through a tube via the groin, under a short general anaesthetic. The complication rate is very low, and recovery is usually very swift. Usually, the only symptom post-surgery is a sore leg for a few days following surgery.

If you have been diagnosed with a hole in the heart and you would like to talk with a specialist, visit cardiologist Dr Mark Mason’s profile here to schedule a consultation.