Heart Hole Dangers: Stroke Risk And Causes

how can a hole in the heart cause a stroke

A hole in the heart, known as patent foramen ovale (PFO), is a common condition that affects around a quarter of the population. While most people with PFO are asymptomatic and never even know they have it, the condition can put some at risk of stroke. This is because PFO creates a pathway for blood clots to travel to the brain, potentially causing a stroke. In fact, PFO is often found to be a contributing factor in unexplained strokes, particularly in younger patients. In such cases, a minimally invasive procedure can be carried out to close the hole and reduce the risk of future strokes.

Characteristics Values
Name of the hole in the heart Patent Foramen Ovale (PFO)
Prevalence of PFO About 25% in the general population
Prevalence of PFO in patients with a stroke of unknown cause 40-50%
Cause of PFO Failure of the foramen ovale to close after birth
Risk associated with PFO Increased risk of stroke
Mechanism of stroke Blood clot travelling through PFO to the brain
Type of stroke Cryptogenic (unknown cause)
Treatment options for PFO PFO closure, blood thinners, aspirin

medshun

Patent Foramen Ovale (PFO) is a common condition where a hole in the heart fails to close after birth

Patent Foramen Ovale (PFO) is a common condition affecting more than a quarter of the population. It is a hole in the heart that fails to close after birth.

During fetal development, a small opening called the foramen ovale sits between the upper heart chambers, allowing blood to bypass the non-functioning fetal lungs. When a newborn takes its first breath, blood pressures change, and the foramen ovale flap closes. However, in about 25% of people, this flap remains open, resulting in a PFO.

Most individuals with PFO are unaware of their condition and do not experience any adverse health effects. Only a small amount of blood leaks from the left to the right atrium, causing a slight increase in blood flow to the lungs. However, problems can arise when pressures within the heart change, allowing blood to flow from the right atrium to the left.

The presence of a PFO increases the risk of stroke. If a blood clot forms in the leg, it can travel through the PFO to the left side of the heart and then to the brain, blocking blood flow and causing an ischemic stroke. This condition is often discovered after a stroke, especially in younger patients.

While PFO does not directly cause strokes, its presence can facilitate the movement of blood clots to the brain, resulting in serious health consequences. Treatment options for PFO include catheter-based procedures, heart surgery, or medications such as antiplatelet or anticoagulant drugs to prevent blood clots.

medshun

PFO doesn't always cause complications, but it can increase the risk of strokes and blood clots

Patent foramen ovale (PFO) is a small hole between the upper right and left chambers (atria) of the heart. This hole is present in every human fetus, allowing blood to bypass the fetal lungs, which are not yet functional. When a newborn takes its first breath, blood pressures change and the foramen ovale flap typically closes within a few months. However, in about 25% of people, this hole remains open, resulting in a PFO.

While PFO often causes no symptoms and many people with this condition don't even know they have it, it can increase the risk of strokes and blood clots. This is because the hole allows blood to flow between the atria, and if a blood clot travels from the right atrium to the left, it can then be pumped out to the blood vessels of the body. If the clot reaches the brain, it can cause an ischemic stroke by blocking blood flow. Additionally, clots can damage other organs, such as the kidneys or the heart.

In most cases, PFO doesn't cause any complications, and treatment is not usually necessary. However, for those at risk of stroke or blood clots, treatment options include medications to prevent blood clots, such as aspirin or warfarin, and closure of the hole using a catheter or surgery.

It's important to note that having a PFO doesn't necessarily mean a person will experience a stroke or blood clot. Other factors, such as age and overall health, also play a role in an individual's risk.

Intubation After Stroke: When and Why?

You may want to see also

medshun

Cryptogenic strokes are those that occur without a known cause

A hole in the heart, known as patent foramen ovale (PFO), is a common condition that affects around a quarter of the population. It is a type of congenital heart defect where there is a hole in the wall of tissue (septum) between the left and right upper chambers of the heart (atria). While most people with PFO are asymptomatic and never even know they have it, it can put some at risk of a stroke. This is because the hole can allow blood clots to travel from the body, through the heart, and up to the brain, causing a blockage and resulting in a stroke.

A stroke that occurs without a known cause is called a cryptogenic stroke. Cryptogenic strokes account for about 1 in 3 ischemic strokes and up to half of all stroke cases, especially in younger patients. In about 30 to 50 percent of patients with cryptogenic strokes, a PFO is found to be a contributing factor. However, it is important to note that PFO itself does not cause the stroke, but rather creates a pathway for blood clots to travel to the brain.

The diagnosis and treatment of cryptogenic strokes can be challenging due to their unknown cause. Healthcare providers may use various tests, such as neurological exams, electrocardiograms (EKG), electroencephalograms (EEG), and prolonged cardiac monitoring, to confirm that a stroke has occurred. While the specific cause of a cryptogenic stroke may remain elusive, identifying it as such is crucial for developing targeted treatment plans to prevent recurrent strokes.

To reduce the risk of recurrent strokes in patients with cryptogenic strokes, providers may recommend anticoagulant medications (blood thinners) to reduce the likelihood of blood clots. Additionally, lifestyle changes, such as managing blood pressure and cholesterol levels, maintaining a healthy weight, and engaging in regular physical activity, can also help lower the risk of future strokes.

In some cases, more invasive procedures may be considered to address the underlying PFO. For example, new catheter-based treatments involve implanting a small device through a catheter inserted into a vein in the groin area to close the PFO and prevent blood clots from passing through.

medshun

Up to 50% of cryptogenic stroke patients are found to have PFO

Patent Foramen Ovale (PFO) is a hole in the heart present in more than a quarter of the population. It is a normal occurrence before birth but may fail to close after birth. When a newborn takes its first breath, blood pressures change and the foramen ovale flap closes. Within a few months, it has sealed completely in about 75% of people. When it remains open, it is called a patent foramen ovale or PFO.

While most people with PFO never know they have it, it can be the cause of a cryptogenic stroke. A cryptogenic stroke is a stroke with no known cause. Up to 50% of cryptogenic stroke patients are found to have PFO. This is because, in some people, PFO can create a way for a blood clot to travel to the brain and cause a stroke.

PFO is most commonly found during tests for heart-related problems, such as atrial fibrillation. While PFO doesn't directly cause strokes, it can allow blood clots to travel from the body to the brain, potentially resulting in a stroke. This is known as a paradoxical embolism.

Several studies have found a high prevalence of PFO in patients with cryptogenic stroke. For example, a study of 712 patients who presented with ischemic stroke found that 18% had cryptogenic strokes, and of those, 59% had PFO. Another study of 308 patients with cryptogenic stroke or transient ischemic attack (TIA) found that 69% had PFO.

The risk of stroke appears to be higher when PFO is associated with other factors such as an atrial septal aneurysm, a Eustachian valve, or a large shunt. Additionally, the risk of stroke may be higher in older patients with PFO.

In recent years, new devices and procedures have been introduced to close PFO and reduce the risk of stroke. These include catheter-based treatments and devices such as the Amplatzer PFO Occluder and the Cardioform Septal Occluder.

medshun

PFO can be closed with a minimally invasive procedure, reducing the risk of future strokes

A patent foramen ovale (PFO) is a hole between the upper two chambers of the heart that doesn't close properly after birth. In most people, a PFO is harmless and doesn't require treatment. However, in some cases, it can allow blood clots to pass from the right side of the heart to the left, potentially leading to a stroke.

If you've had a stroke and have a PFO, closing the PFO can help reduce the risk of future strokes. PFO closure is a minimally invasive procedure that can be performed using a catheter-based technique. During the procedure, a small device called an occluder is guided into the heart to close the PFO and prevent blood clots. The device remains in the heart permanently, and most patients recover within a week.

One such device is the Amplatzer™ Talisman™ PFO Occluder, which has been proven to reduce the risk of recurrent strokes. It consists of two circular wire-mesh discs covered in medical fabric that close the PFO between the two upper chambers of the heart. The procedure to implant the device is minimally invasive and is performed in a heart catheterization laboratory. It typically lasts between one and two hours and involves making a small incision, usually in the right groin area, to insert a catheter that guides the device into the heart.

Another device that has been proven effective is the Cardioform Septal Occluder, which is similar to the Amplatzer™ Talisman™ PFO Occluder. These devices provide a less invasive alternative to open-heart surgery, which is rarely performed to close a PFO unless it is done in conjunction with another surgery.

PFO closure is recommended by the American Academy of Neurology for patients under 60 who have had a cryptogenic stroke and have a PFO. By closing the PFO with these minimally invasive procedures, patients can significantly reduce their risk of future strokes and improve their long-term health outcomes.

Frequently asked questions

A hole in the heart, or Patent Foramen Ovale (PFO), is a small opening in the wall of tissue (septum) between the heart's left and right upper chambers (atria).

PFO is very common, with more than a quarter of the population having this condition.

PFO does not directly cause a stroke, but it can increase the risk by creating a pathway for a blood clot to travel to the brain.

Signs of a stroke include sudden loss of balance, vision loss, facial numbness or drooping, arm weakness or numbness, and slurred speech.

A hole in the heart can be repaired with a minimally invasive procedure called PFO closure, where a small device is implanted to close the hole and prevent blood clots from passing through.

Written by
Reviewed by
Share this post
Print
Did this article help you?

Leave a comment