Hole between the upper heart chambers (PFO or ASD)

Overview

A PFO can rarely let a clot cross to the brain and cause a stroke.

A large ASD can strain the right side of the heart over years.

Symptoms

Common signs:

• Hole between upper heart chambers

Less common

• Shortness of breath with exercise (large ASD)
• Migraines (PFO)

When to get medical care

Causes

Born with it.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Possible complications

• Stroke

Diagnosis

An echo finds it.

Tests

Tests, if needed:

• Echocardiogram with bubble test:

Treatment

Most PFOs need nothing.

Self-care

• Keep follow-ups for ASD
• Tell doctors about it before diving or surgery
• Keep follow-up echos

Catheter closure for large ASDs or after some strokes.

Prevention

To lower your risk or prevent problems:

• There is no known way to prevent it. Early checkups help find it sooner.

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a cardiologist (heart doctor).

Living with it

Support groups and helplines

• American Heart Association: Plain-language heart information and a support network for patients.

Children, pregnancy, and older adults

• Children: Small ASDs often close on their own.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• This condition needs closer checkups during pregnancy. Plan ahead with your doctor.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

Usually harmless.

Closure procedures have high success rates.

Getting ready for your visit

Bring a list of your symptoms and medicines.

Questions to ask

• Should it be closed?
• Is it safe to scuba dive?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Hole between the upper heart chambers (PFO or ASD)