Cardiovascular Medicine Book

http://www.fpnotebook.com/

Patent Foramen OvaleAka: PFO

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  1. Epidemiology
    1. Prevalence: 25%
  2. Pathophysiology
    1. Incomplete closure of the atrial septum
      1. Septum primum and secundum fail to fuse
      2. Creates a flap opening in the atrial septal wall
    2. Persistent path between atrial chamber into adulthood
  3. Associated findings
    1. Patent Foramen Ovale Aneurysm (uncommon)
    2. Fenestrations
  4. Management
    1. No management needed for most patients
    2. Single cryptogenic stroke
      1. See Prevention of Ischemic Stroke
      2. Antiplatelet agents
    3. Recurrent cryptogenic stroke (Idiopathic CVA)
      1. Patent Foramen Surgical Closure
  5. Complications
    1. Consider as benign incidental finding in most patients
    2. Cryptogenic Stroke (CVA without definitive cause)
      1. Prospective trials do not show increased CVA risk
  6. References
    1. Nelson (2007) MP Primary Care Medicine, Lecture

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