Pectus Excavatum, Patent Foramen Ovale, and Migraine in the Same Patient

A patent foramen ovale (PFO) can be found in patients with pectus excavatum (PE); PFO can be associated with migraines.

A 22-year-old woman presents a PE and a history of recurrent migraines. Pulsed oxygen saturation at effort decreased from 97% to 92%. A transthoracic echocardiography showed a PFO. Five years after the Ravitch procedure, pulsed oxygen saturation remained stable at effort, no PFO was shown on transthoracic echocardiography, and migraine disappeared.

Our observation is the first description of the PE, PFO, and migraine association. The correction of PE has allowed the closure of the PFO and improved migraines.

This case report suggests that a patient presenting a PE should undergo a comprehensive cardiorespiratory evaluation. Similarly, patients with a symptomatic PFO and PE should benefit from a multidisciplinary discussion involving thoracic surgeons to determine the best approach to treat the PFO.