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A hole in the heart?

» When a PFO is a problem

» Time to fix it?

The PFO-migraine link

If you suffer from painful migraines with auras (blurred vision, blind spots and other visual problems that occur before or during the headache), you might have a patent foramen ovale (PFO). Research suggests that the two conditions are linked, although they aren’t sure exactly what causes the connection. In any case, surgically repairing the PFO isn’t recommended for people with migraines, as much more research needs to be done in this area.

About 25 percent of the population has a hole (or shunt) between two chambers of the heart (the atrial chambers), which doesn’t close properly at birth. This is called a patent foramen ovale, or PFO. Most people will never know they have the condition, because there are no symptoms and it causes no problems. But having a PFO could potentially put you at greater risk of having a stroke.

When a PFO is a problem

The danger occurs when you have blood clots in your bloodstream. If a clot travels through the hole instead of taking the normal pathway through the heart, it can bypass the lungs, travel to the brain and cause a stroke. About 40 percent of people who have strokes with unknown causes have a PFO, and it’s more commonly identified among those who are younger than 55 years old.

There’s no way to prevent a PFO, and there are no known risk factors, although there may be a genetic factor. Most people who learn that they have the condition were being screened for another heart condition when it was discovered, typically by an echocardiogram.

Time to fix it?

Most people don’t need to seek treatment for a PFO, but if you have one and you’ve already had a stroke, your primary care provider may prescribe blood thinners, which may help prevent subsequent strokes. In some cases, he or she may suggest repairing the hole. This can be done by open heart surgery or using cardiac catheterization, during which a device is inserted through a blood vessel in the groin.

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