PFOs and Migraine

(LifeWire) - Could your heart be hurting your head -- literally? And could healing your heart mend your aching head? Medical experts are divided over whether an opening between the two upper chambers of the heart -- which is called a patent foramen ovale (PFO) -- could be involved in causing a kind of severe headache known as a migraine with aura.

The actual opening is called the foramen ovale. During pregnancy, while the fetus is growing, this opening is important, because the mother provides both blood and oxygen and the nutrients it carries to her young one. The blood doesn't need to circulate through the lungs of the fetus in the mother. The foramen ovale in the heart of the fetus is a kind of shortcut that allows blood to bypass the lungs and circulate through the rest of the body more swiftly.

Normally, this opening, or foramen ovale, closes after birth. In some people, however, it remains open. As a result, these people have a PFO, in which some nonoxygenated blood may be moving into the bloodstream without having been supplied with oxygen. This most likely happens when extra pressure occurs in the chest, which can occur, for instance, during coughing and sneezing. Learn more about PFO .

Some medical studies have suggested that 40% to 60% of people who get migraine headaches with an aura (a migraine that announces its imminent arrival via warning signs that are usually visual) may have a PFO. Only about 20% to 30% of people in the general population are estimated to have a PFO. The statistical difference drives the theory connecting these migraines and PFOs.

 But this connection between hurt heart and hurting head is both controversial and hypothetical.

A research group called Migraine Intervention with Starflex Technology (MIST) has published a number of studies examining the relationship between the PFO and migraine, looking at the possibility that closing the PFO might prove to be a treatment for the migraine.

Results released from one trial, called the MIST-I, did not reach the goal of proving that 40% of people in the trial who had their PFO surgically closed were migraine-free 6 months after the operation.

Other researchers, who have analyzed this method and previous MIST trials, question whether these studies were well designed. As a result, the data that were collected and the results themselves have been looked into with doubt. Because of these doubts, a second trial, named MIST-II, was closed. However, results from other trials on this question are still being awaited.

For the time being, the American Headache Society has offered this advice: Migraine patients should not be routinely screened for PFO, and PFO closure should not be performed on patients unless they are enrolled in a reputable clinical trial.

Treating the heart to get to the head may be an idea a little ahead of its time. More about PFO and migraines.

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