Patent foramen ovale

PFO is reportedly found in approximately 10% of patients undergoing contrast echo.[5]Fisher DC, Fisher EA, Budd JH, et al. The incidence of patent foramen ovale in 1,000 consecutive patients. A contrast transesophageal echocardiography study. Chest. 1995 Jun;107(6):1504-9. http://www.ncbi.nlm.nih.gov/pubmed/7781337?tool=bestpractice.com In one autopsy series, PFOs were reported of 0.2 to 0.5 cm in 29% of patients and 0.6 to 1.0 cm in 6% of patients.[6]Thompson T, Evans W. Paradoxical embolism. Q J Med. 1930 Jan 1;23(90):135-52. Another study showed an incidence of 27%, with PFOs varying from 1 to 19 mm in size.[7]Hagen PT, Scholz DG, Edwards WD. Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts. Mayo Clin Proc. 1984 Jan;59(1):17-20. http://www.ncbi.nlm.nih.gov/pubmed/6694427?tool=bestpractice.com The incidence declines with age, suggesting that some PFOs may close anatomically even in adulthood. There is no sex or age predominance. Epidemiologic studies in large populations suggest some racial and ethnic differences in incidence, although other studies are unsupporting.[8]Gupta V, Yesilbursa D, Huang WY, et al. Patent foramen ovale in a large population of ischemic stroke patients: diagnosis, age distribution, gender, and race. Echocardiography. 2008 Feb;25(2):217-27. http://www.ncbi.nlm.nih.gov/pubmed/18269568?tool=bestpractice.com [9]Rodriguez CJ, Homma S, Sacco RL, et al. Race-ethnic differences in patent foramen ovale, atrial septal aneurysm, and right atrial anatomy among ischemic stroke patients. Stroke. 2003 Sep;34(9):2097-102. http://stroke.ahajournals.org/content/34/9/2097.full http://www.ncbi.nlm.nih.gov/pubmed/12920255?tool=bestpractice.com Due to increased usage of contrast echo and availability of percutaneous treatment, PFO is increasingly recognized in the overall population, with higher numbers in stroke survivors.