Important Actionable Clinical Physiological Consequences of a Patent Foramen Ovale (PFO) other than Stroke

The work-up to detect a Patent Foramen Ovale (PFO) is usually done after a patient has a stroke. However, patients with PFOs may present with non-stroke signs and symptoms that have important actionable clinical physiological consequences not well known to be associated with a PFO or not considered, including hypoxia, carbon dioxide retention, higher core temperature that worsens hypoxia, high altitude effects with or without Altitude Decompression Sickness in a plane or mountain climbing, unfiltered fat emboli, unfiltered air bubbles, and SCUBA diving Decompression Sickness. Some of these can negatively affect the quality of life, and cause profound medical changes, including death. This information, some of which is only recently available, presented succinctly and comprehensively for the first time, will provoke thoughtful discussion between physicians and patients with PFOs particularly for those whose PFOs get larger with aging. A suggestion can be made to close the foramen if there are no medical contraindications for closure.