Cleveland Clinic Children's doctor listening for baby's heart and lung sounds with a stethoscope.

Patent Foramen Ovale (PFO)

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Everyone is born with a small opening (flap) in their heart. It usually closes within a couple months after birth. But what happens if it doesn’t close completely?

This is called patent foramen ovale (PFO). And most people with it may never need treatment — even into adulthood. Other times, this congenital (born with it) heart condition may be associated with other health conditions, like migraine headaches, low blood oxygen levels (hypoxemia), strokes or mini-strokes (transient ischemic attack or TIA). So when you hear that your child may have this condition, you may wonder, “Will they be OK?” And, “Where can I get the best care for them?”

Cleveland Clinic Children’s pediatric cardiologists have experience diagnosing — or, if needed, treating — patent foramen ovale with excellent results. We make sure your child (and family) gets all of the care and emotional support they need from the moment you make that first appointment.

Why Choose Cleveland Clinic Children’s for Patent Foramen Ovale Care?

Caring approach:

We understand the important role you play in your child’s experience at Cleveland Clinic Children’s. We always communicate openly with you and your child every step of the way.

Patient-centered care:

Our pediatric cardiologists work with you and your family to make sure the treatment we plan is highly personalized to your child’s needs. We want them to have the best results — and quality of life. Meet our team.

Virtual visits:

Getting kids ready and out the door can be tough, especially if they aren’t feeling 100%. That’s why we offer virtual visits for some appointments. With an internet connection and a smartphone, tablet or computer, you can meet one-on-one with your child’s provider from the comfort of home.

National recognition:

Cleveland Clinic Children’s is a trusted healthcare leader. We’re recognized throughout the U.S. for our expertise and care.

Diagnosing Patent Foramen Ovale (PFO) at Cleveland Clinic Children’s

A patent foramen ovale means the small, flap-like opening in between the upper chambers of your child’s heart didn’t close after birth like it usually does. When this happens, the flap may let blood or blood clots flow through their heart’s chambers.

Your child might not have any symptoms. The PFO might just show up during a routine physical exam or test. Or, their skin may turn a bluish color when they cry — particularly around their lips, gums, eyes and nails. This may also happen when they cough, sneeze or poop.

What to expect at your first visit

When your child comes to Cleveland Clinic Children’s, we’ll take time to get to know them, and you. It’s important for our team of providers to understand your child’s story — what’s been going on, how long it’s been happening and how it’s affecting their life.

That’s why we’ll ask them (and you) a lot of questions about how they’re feeling right now and also their health history. We’ll give your child a physical exam and might also order some tests.

Testing for patent foramen ovale

To get a better understanding of what’s going on with your child’s heart, we might order tests like:

Your provider may also order a bubble study to help diagnose PFO. This involves injecting a saline solution into a blood vessel to see blood flow through your child’s heart during an echocardiogram.

Meet Our Patent Foramen Ovale Team

Cleveland Clinic Children’s offers compassionate, skilled, team-based care that focuses on your child’s needs. Each provider joins the team based on these needs — which means no child’s care team is ever the same. Your child’s providers work together to plan the most personalized treatment and support. Your child’s care team could include:

Pediatric cardiologists
Pediatric interventional cardiologists
Pediatric cardiac surgeons
Pediatric radiologists specializing in cardiac imaging
Nurse practitioners
Physician assistants
Child life specialists

Providers Who Treat Patent Foramen Ovale (PFO)

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Treating Pediatric Patent Foramen Ovale at Cleveland Clinic Children’s

Your child’s treatment plan will be highly personalized. That’s because no two children have the same symptoms or risks. We work with you and your family to make sure your child’s treatment matches their unique symptoms, diagnosis and needs.

If your child has patent foramen ovale but doesn’t have any symptoms, they won’t need any treatment. But their providers may keep a close eye on them to make sure symptoms don’t appear. We call this watchful waiting. Many times, a PFO without symptoms will close on its own in the first few years of life.

If your child has a stroke or mini-strokes and has PFO, our providers may prescribe medications called anticoagulants to reduce the risk of blood clots and symptoms from coming back. They may also recommend doing a minimally invasive catheterization to seal the flap. Research has shown closing a PFO may help prevent future strokes.

Surgery for patent foramen ovale

Sometimes, your child may need more complex heart surgery. This may happen if medications and catheterization didn’t work as expected. Or if your child also has other pediatric and congenital heart conditions along with pediatric PFO.

Your child’s provider will go over what option they feel is right for your child’s diagnosis and needs. They’ll walk you through every step of what to expect before, during and after surgery. And they’ll explain what you need to know as your child recovers after leaving the hospital.

Taking the Next Step

Learning your child has a congenital heart condition like patent foramen ovale can cause a lot of stress and worries. But most people with patent foramen ovale can lead full lives without any symptoms or treatment. Cleveland Clinic Children’s providers are here to help ease your stress and give your child the very best treatment possible. And if they need lifelong cardiology care, their pediatric care team will work with our adult care providers at Cleveland Clinic to make sure the transition is comfortable and easy.