PERSISTENT FORAMEN OVALE AND ATRIAL SEPTAL DEFECT – SMALLCONGENITAL HEART MALFORMATIONS WITH SIGNIFICANT CARDIOVASCULARCONSEQUENCES

Abstract

Persistent foramen ovale (PFO) and atrial septal defects (ASD) are life-changing diagnoses that shed light on hidden health conditions that often go unnoticed. Persistent patent foramen ovale and atrial septal defects are congenital cardiac malformations characterized by abnormal communication between the atria of the heart. PFO is a physiological interatrial communication that is necessary for foetal circulation. The opening is still present in the newborn, but over time the two edges, the septum primum and septum secundum, fuse, creating a barrier between the left and right atria. A PFO occurs when the oval opening fails to close after birth, potentially allowing shunting of blood from the right to the left atrium. This condition can be asymptomatic in many individuals but is associated with paradoxical embolism, transient ischemic attack (TIA), stroke, and other cardiovascular events. Conversely, ASD refers to a diverse group of defects in which there is a persistent opening in the interatrial septum, resulting in significant hemodynamic changes due to left-to-right shunting of blood. Symptoms may include exercise intolerance, fatigue and atrial arrhythmias of varying severity depending on the size and type of defect. Diagnosis usually includes echocardiography, computed tomography and nuclear magnetic resonance imaging. Management strategies range from conservative monitoring and treatment to interventional procedures via catheter-based technique or surgical correction. We present a clinical case series from a screening program conducted for available PFO and ASD in patients with cryptogenic stroke, TIA and other embolic events.