Patent Foramen Ovale and Blue Baby

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Patent Foramen Ovale and Blue Baby

• Nick, Natalie, Rose, Sarah

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Situation

• Bob and Saras baby did not pink up after
  delivery and remained cyanotic (blue).
• Ultrasound revealed a PFO (Patent Foramen Ovale)
• What is the A P of PFO and what is blue baby
  syndrome?
• Will a two-year-old with PFO be cyanotic?

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Normal The Foramen Ovale
Foramen Ovale

• In the fetus, a hole connecting the right and
  left atria.
• The foramen is used for blood to bypass the lungs
  since the mother supplies oxygen.
• Blood pressure closes the foramen after birth but
  it is not sealed for a year.

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Formation of the Foramen Ovale

• Week 4 septum primum begins forming
• Week 5-6 Foramen primum opening in septum
  primum. Closes and foramen secundum forms.
• Week 7-8 septum secundum begins to form in a
  crescent. Oval opening of crescent foramen
  ovale.

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Anatomy of the Foramen Ovale
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Problem The Patent Foramen Ovale

• If the foramen does not fuse after 1 year, it is
  known as a patent foramen ovale.
• 1 in 4 people have a PFO.
• This only becomes a problem when combined with
  another heart defect or a loosened blood clot.

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Fetal vs. Adult Heart Circulation
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Blue Baby Syndrome

• Deoxygenated blood is circulated throughout the
  body.
• It can be caused for many reasons including
• Incompatibility of fetal and maternal blood
  types.
• Narrow pulmonary artery.
• Child consumes tap water with a high nitrate
  concentration.
• Blood bypassing the right ventricle (and in turn
  the lungs) as in PFO.

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Will this affect a two-year-old?

• Not necessarily
• If putting extreme pressure on the chest, some
  blood may travel through the PFO.
• a BM Strain
• Coughing
• Sneezing
• Heart rhythm abnormality
• Or other heart problems
• Possibility of stroke (unlikely at two years)
• Migraine correlation

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Treatments for PFO

• No general treatment
• Stroke treatments if at risk
• blood thinners
• Surgery
• open heart
• cardiac catheterization

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Analogy

• Foramen ovale circulation two lane highway
  travel.
• Blood passing through an unfused septum in an
  adult passing a car in a no passing zone.
• Blood clot passing through septum in adult
  oncoming car.
• Stroke wreck.
• On the other hand.
• Blood passing through a fetal septum passing in
  a designated passing zone.

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References

• The Cleveland Clinic Information Center.
• http//www.clevelandclinic.org/health/health-info/
  docs/3400/3454.asp?index11626
• Marcy Thomas. Oct. 5, 2005.
• http//www.wellesley.edu/Biology/Courses/111/mamma
  lian.html
• Mayo Clinic.com. Oct. 4, 2006.
• http//www.mayoclinic.com/health/patent-foramen-ov
  ale/DS00728
• Silverthorn.
• Langmans Medical Embryology. 6th edition.
  Sadler, T.W. 1990.
• Pictoral Human Embryology. Gilbert, S.G. 1989.