Patent Foramen Ovale (PFO) and atrial septal defect (ASD) are communications between the right and left atria of the heart. Such a communication is necessary before birth, but in most people it closes shortly after birth.

A PFO is a slit like hole between the atria and is present in perhaps 20% or so of the population and often causes no problems and needs no treatment. A PFO however can allow some blood to go from the right to the left side of the heart under some circumstances without passing through the lungs. In some cases of TIA, stroke and heart attack it is believed that blood clots from the veins of the body pass through a PFO and cause these complications. If that is likely to be the case then closing the hole, often with a transcatheter device (PFO closure) may be recommended.

National Heart Lung and Blood Institute

An atrial septal defect (ASD) is usually a larger hole between the atria. It can cause the same problems as some PFOs however because it can allow significant flow of blood across the septum (a shunt) it can cause problems for the heart and lungs. Although small ASDs often cause few problems, under some circumstances closure of the ASD either with transcatheter closure or a surgical operation may be recommended.

When assessing PFO or ASD in the clinic your cardiologist will need to take a history and perform a physical examination. In addition they will want to perform some tests which, will often include blood tests, a chest x-ray, ECG, echocardiogram (often with a bubble echo), and transoesophageal ultrasound (TOE).

Dr Dalby will discuss these tests, their implications and any subsequent tests, treatment or follow up with you so that you may reach a mutually agreeable management plan.