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What is the Fossa Ovalis?
The fossa ovalis is a structure located in the human heart. This structure, a shallow depression, forms in the right atrium just after birth. The formation of the fossa ovalis divides the heart into two parts, right and left. This allows the cardiovascular system to efficiently distribute oxygenated blood throughout the body.
Prior to birth, the area that will become the fossa ovalis is open. This open structure, then known as the foramen ovale, allows blood to flow freely from the right atrium of the embryonic heart to the left without passing through the lungs. Blood must bypass the fetus's lungs because they are not used until birth, and the blood received from the mother via the umbilical cord is already oxygenated.
Within the first three months after birth, the foramen ovale typically closes and becomes the fossa ovalis. As the infant uses his lungs, pressure increases in the left atrium. This increased pressure forces the foramen ovale shut. Complete closure may not occur until the child is two years old or, in some cases, not at all.
In up to 34% of the population, the foramen ovale does not completely close, and a small hole remains where the fossa ovalis should form. This condition, known as a patent foramen ovale (PFO), may cause no symptoms or problems whatsoever for the patient. Many people do not even realize that they have a PFO unless the condition is detected by medical tests such as an echocardiogram.
Incomplete formation is not known to be the definitive cause of any medical conditions or complications. Some studies, however, do find a correlation between this condition and an increased risk of stroke. Patients with a hole in the fossa ovalis may therefore receive aspirin therapy or treatment with other blood thinners in an attempt to prevent blood clots from crossing the defect and to minimize the risk of stroke. Surgery to close a PFO is often recommended for patients who have experienced strokes without any other apparent cause.
Having a PFO may also cause patients to suffer migraine headaches. Intense migraines, in particular, which include seeing an aura of light as a symptom, seem to be more prevalent among PFO patients. The link between PFO and migraines is stronger and better documented than the link between PFO and strokes, as patients have reported that their migraines stopped after they had operations to repair the defect.
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![The fossa ovalis is a shallow depression that forms after birth in the right atrium.]()
By: blueringmediaThe fossa ovalis is a shallow depression that forms after birth in the right atrium. -
![Patients with patent foramen ovale (PFO) often experience migraine headaches.]()
By: MediablitzImagesPatients with patent foramen ovale (PFO) often experience migraine headaches. -
![Within the first three months after birth, the foramen ovale typically closes and becomes the fossa ovalis.]()
By: Francois du PlessisWithin the first three months after birth, the foramen ovale typically closes and becomes the fossa ovalis. -
![A PFO is often discovered on a routine echocardiogram or in imaging done for other reasons.]()
By: nyulA PFO is often discovered on a routine echocardiogram or in imaging done for other reasons. -
![A PFO may increase a person's risk of stroke, and the complications this type of attack can cause.]()
By: sframeA PFO may increase a person's risk of stroke, and the complications this type of attack can cause. -
![At the time of birth, the pressure inside the baby's heart typically forces a flap of tissue over the foramen ovale.]()
By: Tyler OlsonAt the time of birth, the pressure inside the baby's heart typically forces a flap of tissue over the foramen ovale. -
![Patients have reported that migraines stopped after they had operations to repair a PFO.]()
By: Monkey BusinessPatients have reported that migraines stopped after they had operations to repair a PFO.
Discussion Comments
@KoiwiGal - I think it all depends on how big the hole is. Since it allows some blood to bypass the lungs, it can make breathing very difficult, especially for a baby who won't have very developed lungs anyway.
But, if it is just a small hole, I don't think it would make all that much difference to blood flow.
I didn't know about the link between PFO and migraines though, or even the link between PFO and strokes.
I guess I thought the surgery was always to make it easier for blood to get to the lungs.
I was always told that my sister was born with a hole in her heart. I thought it must be an extraordinary thing to be born with, but when I studied the heart anatomy in biology I was surprised to learn that it's actually quite common.
I didn't realize until this article though, that in some people it never completely closes. I thought they always had to go in and close it if it doesn't eventually close by itself.
They didn't end up having to close my sister's because it did close by itself, but for a while she was a very sick baby.
I just remember all the adults being very worried and being taken to see her in the hospital.
I was doing a dissection in biology class on a sheep heart, where we had to identify all the different parts of the heart, including the fossa ovalis.
To my surprise, there was an extra hole in my heart, which puzzled me for a while, because I couldn't work out how it matched the text book.
Then my teacher came over and explained that it was incomplete formation of the fossa ovalis, so the poor sheep had a hole in its heart.
It must just have not bothered the sheep, as it was an adult sheep heart and if it had affected it at all, I imagine it would have been culled as a lamb.
I guess domestic sheep don't really live strenuous lives anyway, that might need them to be at peak fitness.
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