What to Do If Your 6-Month-Old Baby Has a Patent Foramen Ovale?

What should I do if my six-month-old baby’s oval foramen has not closed?

My baby had an echocardiogram at birth, which revealed a patent foramen ovale (PFO).
After three months, a follow-up showed two small openings measuring 0.3 and 0.4 cm.
The doctor advised further monitoring.
Now, at five and a half months, during the follow-up, the openings remain but have decreased to 0.3 and 0.2 cm.
Is a patent foramen ovale considered a congenital heart defect? Will it have any impact on my baby's future? Are there treatment options available?

Yu Mama, 30~39 year old female. Ask Date: 2012/01/30

Dr. Xiao Kaiwen reply Pediatrics

In most cases, the patent foramen ovale (PFO) will close on its own over time without any long-term complications, so there is no need for excessive concern.
Moreover, your child's size is considered small, and it is also decreasing.
Regular follow-up with a pediatric cardiologist is recommended.
The following follow-up examination methods are suggested based on the size of the defect measured:
1) If the defect size is 3.0 mm or less (including 3.0 mm), it is recommended to schedule another echocardiogram after the child turns one year old to confirm that the defect has completely closed.
2) If the defect size is greater than 3.0 mm and less than or equal to 5.0 mm, it is recommended to schedule another echocardiogram between six months and one year to confirm that the defect has completely closed.
3) If the defect size is between 5.0 mm and 8.0 mm, another echocardiogram should be scheduled in three to six months.
If the defect has completely closed at that time, no further follow-up is needed.
If the defect remains and its size is 5.0 mm or less (including 5.0 mm), it is recommended to schedule another echocardiogram after the child turns one year old to confirm that the defect has completely closed.
4) If the defect size is greater than or equal to 8.0 mm, it is recommended that a pediatric cardiologist conduct follow-up examinations and schedule subsequent echocardiograms based on the child's clinical symptoms.

Reply Date: 2012/01/30

More Info

Patent Foramen Ovale (PFO) is a condition where the foramen ovale, a small hole in the heart that allows blood to bypass the lungs during fetal development, fails to close after birth. This is a common occurrence, as many infants are born with a PFO, and in most cases, it closes naturally within the first year of life. However, in some instances, it may remain open, which can lead to concerns about potential complications.

In your case, the echocardiograms have shown that your baby has two small openings measuring 0.3 cm and 0.4 cm, which have since reduced to 0.3 cm and 0.2 cm. This reduction in size is a positive sign, as it indicates that the condition may be improving. It is important to understand that a PFO is not classified as a congenital heart disease in the same way that other more serious heart defects are. Many individuals with a PFO live healthy lives without any symptoms or complications.

The potential impact of a PFO on your baby's future health largely depends on whether it is associated with any other heart defects or conditions. In most cases, a PFO does not cause any problems, and many people are unaware they have it. However, in rare cases, it can lead to complications such as paradoxical embolism, where a blood clot can pass from the right side of the heart to the left side and potentially cause a stroke. This is more of a concern in older children and adults rather than infants.

As for treatment options, most pediatric cardiologists recommend a watchful waiting approach for infants with a PFO, especially when there are no associated symptoms or complications. Regular follow-up appointments with a pediatric cardiologist are essential to monitor the condition. If your baby shows any signs of distress, such as difficulty breathing, excessive fatigue, or cyanosis (bluish skin), it is crucial to seek immediate medical attention.

In summary, a PFO is a common finding in infants and is usually not a cause for concern. The fact that your baby's openings are decreasing in size is encouraging. Continue to follow up with your pediatric cardiologist, who will provide guidance on monitoring and any necessary interventions. It's also beneficial to maintain open communication with your healthcare provider about any concerns you may have regarding your baby's health and development. Regular check-ups will help ensure that any potential issues are addressed promptly.

Similar Q&A

Can Medications Treat Patent Foramen Ovale in Children?

I have a few questions for the doctor: 1. My child has a patent foramen ovale (PFO) with a size of 2.5mm. The doctor mentioned there is a 95% chance it will close. Is 2.5mm considered small? Will it close? 2. I heard that a patent foramen ovale can be treated with medication. Is ...

Dr. Cai Zhengxian reply Pediatrics
Dear concerned mother, The foramen ovale is a necessary cardiac opening in the fetus while in the mother's womb, which maintains important blood circulation. After birth, about 70% of newborns will close it immediately, and 90% will close it within three months. If it remai...

Understanding Patent Foramen Ovale in Children: Risks and Treatment Options

Hello, doctor. A fourth-grade student was found to have a heart murmur, arrhythmia, and left axis deviation. They have been monitored at a major hospital for several years, and the diagnosis is an open foramen ovale. Now in the first year of junior high, is it feasible for them t...

Dr. Xie Wanghu reply Pediatrics
The foramen ovale typically closes between birth and six months of age. If it remains open, it is referred to as an atrial septal defect (ASD). The management depends on the size of the defect; if the opening is too large, it can affect blood flow direction and growth and develop...

Introducing Solid Foods for Infants with Hydrocephalus and Heart Conditions

My baby has 0.7 cm of hydrocephalus (it is still uncertain whether it is true hydrocephalus), and he also has a patent foramen ovale. However, the width of the patent foramen ovale has already decreased compared to the measurement taken at two months during the four-month check-u...

Dr. Xiao Kaiwen reply Pediatrics
Heart conditions that require fluid restriction are usually more severe. Your pediatric cardiologist should remind you that a patent foramen ovale in infants is typically a mild heart issue that often resolves on its own (it may not even be classified as a heart disease), and the...

Managing Pediatric Concerns: Enlarged Left Ventricle and Feeding Issues

Hello, Doctor. I apologize for coming to you again, but I have three questions I would like to ask: 1) Previously, I made an appointment for my baby in mid-June (when the baby was two months old) for a follow-up on "left ventricular dilation" and "patent foramen ...

Dr. Xiao Kaiwen reply Pediatrics
1. It is still important to follow the physician's advice and not to delay examinations too much. 2. If weight gain is normal and activity levels are appropriate during the natural period of milk aversion, it is best to observe without forcing the issue, as this may inadve...