Is a Hole in the Heart Triggering Your Migraines?
Have you been chasing answers for debilitating migraines, especially those that come with strange visual disturbances or numbness? You’re not alone. And surprisingly, the cause may not be in your head at all. It could be in your heart.
Many migraine sufferers don’t realise they could be living with a Patent Foramen Ovale (PFO), a small, flap-like opening between the top chambers of the heart. It’s present in about 1 in 4 adults, and for most, it causes no issues. But for some, it may be linked to recurring migraines, particularly migraine with aura.
What Is a PFO—and Why Does It Matter for Migraine?
As explained on our website, a PFO is a hole in the heart that never properly closed after birth. While this opening allows blood to bypass the lungs during foetal development, it should shut soon after birth. When it doesn’t, it can create a passage for unfiltered blood to cross from the right to the left side of the heart.
Normally, the lungs filter out small clots, air bubbles and waste in the bloodstream. But with a PFO, unfiltered material can bypass the lungs and flow directly to the brain. This, triggering neurological symptoms like migraine, stroke, or even transient ischaemic attacks (TIAs).
“One theory is that small emboli, or chemical substances which would normally be filtered by the lungs, can travel through the PFO and straight to the brain, causing neurological effects.” Hole in the Heart Clinic – About a PFO
The Surprising PFO-Migraine Link
In recent years, growing research has explored this heart-brain connection. Some studies estimate that up to 60% of people with migraine with aura have a PFO, a much higher percentage than in the general population. While not all migraines are caused by a PFO, for those who do have one, closing it or managing the associated blood flow may reduce migraine severity or frequency.
Still, PFO-related migraines are often overlooked because standard heart tests don’t always detect them. That’s where the TCD test comes in.
The TCD Test: A Non-Invasive Look Into Your Brain's Blood Flow
If you’re experiencing migraines and wondering if there’s an underlying heart cause, the Transcranial Doppler (TCD) Bubble Study may be the answer.
“The TCD test is an ultrasound scan that detects abnormal blood flow in the brain—particularly looking for bubbles that pass through a PFO and into the cerebral circulation.” Click here to read more about the TCD study.
Here’s how it works:
- A tiny amount of saline mixed with air (microbubbles) is injected into a vein.
- Using ultrasound probes placed at the temples, doctors monitor whether these bubbles reach the brain, which they shouldn’t.
- If bubbles are detected, it’s evidence of a right-to-left shunt, often caused by a PFO.
This simple, non-invasive, outpatient test can provide powerful insight into whether your migraines may have a hidden cardiovascular cause.
Why It’s Worth Investigating
Many people spend years treating migraines with painkillers, lifestyle changes, and neurologist visits without ever knowing there could be a physical hole in the heart contributing to the problem.
Identifying a PFO doesn’t always mean surgery or closure is needed. But it does mean you have more information to guide your care and possibly reduce stroke risk or other complications too.
And as highlighted in this peer-reviewed research article from Pulsus Journals, PFOs are being found in unexpected contexts, including in patients undergoing unrelated surgeries. This reinforces the idea that PFOs are more common than many realise and deserve greater attention, especially in patients with unexplained neurological symptoms.
What’s Next?
If you experience:
- Frequent migraines with aura
- Visual disturbances or numbness before headaches
- Brain fog
- A history of unexplained stroke or TIA
- Or a family history of cardiac issues
…you may benefit from further investigation.
At Hole in the Heart Clinic, we specialise in screening, diagnosing, and supporting patients with PFO-related conditions. Our cardiologists use the latest diagnostic tools, including the TCD test, to help you uncover the root cause and guide next steps, whether that’s monitoring, medical management, or treatment.
Find out if your migraines are more than neurological. Click here to contact our team.