What Role Does PFO Play in Unexplained Strokes?

A majority of individuals who have strokes are over the age of 60. But what happens when younger individuals have unexplained strokes? What causes these to happen? According to a Newswise release from LifeBridge Health, a patent foramen ovale (PFO) could play a role.

Patent Foramen Ovale (PFO)

According to the Mayo Clinic, a patent foramen ovale (PFO) is:

a hole in the heart that didn’t close the way it should after birth. During fetal development, a small flap-like opening — the foramen ovale — is normally present in the wall between the right and left upper chambers of the heart [and] normally closes during infancy.

This opening helps blood to flow between the chambers of the heart. So PFO is what occurs when that opening does not close. Surprisingly, an estimated 25% of people have PFO. However, it does not affect health in many people, so some may not even know they have it. Thus, the vast majority of PFO require no treatment. Additionally, PFO also rarely shows symptoms.

However, in some cases, PFO may cause aura migraines or unexplained strokes. In fact, the American Heart Association states that nearly 40-50% of unexplained strokes result from PFO. While drugs can be used to address symptoms, PFO causing strokes should be surgically closed. This can be done either through open-heart surgery or through a catheter-closure device.

Cryptogenic Strokes

What are strokes? According to the American Stroke Association, strokes:

occurs when blood [vessels] that [carry] oxygen and nutrients to the brain [are] either blocked by a clot or bursts (or ruptures). When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it and brain cells die.

“Cryptogenic” strokes basically mean an unexplained stroke. Typically, cryptogenic strokes also occur in the absence of high cholesterol or high blood pressure, which can raise the risk of having a stroke. Having PFO can definitely contribute to strokes in people who are generally considered “healthy.”

Unfortunately, it can sometimes be difficult to diagnose PFO. While some cases can be detected using an echocardiogram, PFO can also be missed by the same testing. That’s why doctors suggest that a non-invasive bubble study, to evaluate blood flow in the heart, should be done as well. When performing a bubble study, doctors inject saline with microbubbles into a vein. As the fluid circulates through the heart, researchers can track where the bubbles spread during the echocardiogram. If bubbles only appear on the right side of the heart, that is a good sign. If bubbles move quickly to the left side, this indicates PFO. To definitively diagnose, additional testing is needed, such as a transesophageal echocardiogram.

Symptoms of stroke include:

  • Sudden paralysis in some part of the body
  • Losing consciousness for a short period of time
  • Muscle weakness or numbness in the face, arm, legs, or one side of the body
  • Blurred vision
  • Difficulty speaking or understanding others
  • Dizziness
  • Loss of balance and coordination
  • Severe headache
Jessica Lynn

Jessica Lynn

Jessica Lynn has an educational background in writing and marketing. She firmly believes in the power of writing in amplifying voices, and looks forward to doing so for the rare disease community.

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