Questions Regarding PFO Closure: Insight Needed
I am a 37-year-old female with a medical background that includes POTS and a history of SVT. I also have a duplicate IVC and, following a CT heart angiogram, it was found that I have a PFO. While awaiting a response from my cardiologist, I'm reaching out for some advice. Here’s a brief overview of my medical history: - Age: 37 years - Medical conditions: POTS with episodes of SVT - Anatomy: Duplicate inferior vena cava - Current treatment: Midodrine to manage low blood pressure associated with POTS - No significant past medical issues reported. Recently, I have experienced several troubling symptoms: - Severe migraines - Occasional color changes in my feet and toes, possibly indicative of Raynaud's, as suggested by a vascular study - Profound fatigue - Periodic chest discomfort Additionally, I have a family history of stroke. To date, the evaluations conducted include: - A 2-week event monitor revealing PACs, PVCs, and couplets, along with some sinus arrhythmias. - A vascular exam of my lower extremities resulted in negative findings for Raynaud’s. - Findings from the CT heart angiogram include: 1. Normal coronary arteries 2. A thoracic aorta of normal dimension 3. A patent foramen ovale (PFO) 4. CAD-RADS score of 0/P0 - Blood work (CBC/CMP) returned within normal limits. With all this in mind, I have several questions: 1. Is it common practice in cardiology to recommend closing a PFO in situations like mine? 2. What factors influence the decision to either close the PFO or leave it open? 3. Could any of my symptoms (migraines, arrhythmias, fatigue, chest discomfort) be potentially linked to the PFO, or is it more likely to be an incidental finding? 4. Would it be valid for me to express a desire for the closure of this hole? Adding to my concern is a recent incident in my family: my father-in-law, aged 53, suffered a right-sided stroke attributed to a PFO this past June. This has understandably caused me a great deal of anxiety, as I want to be there for my children for many years to come. I appreciate any medical perspectives you can offer while I await my follow-up appointment. Thank you!
Answers (1)
9/15/2025, 1:40:46 AM
OpenHealth AI
It's understandable to have concerns about your health given your complex history, especially with recent family experiences. Let’s address your questions regarding the PFO (patent foramen ovale) and how it might relate to your symptoms and overall health concerns.
Main Points:
- Closure of a PFO may be considered depending on symptoms, risk factors, and associated medical conditions.
- Various factors influence the decision to close a PFO, and some symptoms may indeed be related to it.
- You have every right to express your desire for closure, especially given your family history and symptoms.
Explanation:
A PFO is a small hole in the heart that didn’t close after birth. For many people, it doesn't cause problems. However, in some cases, it can be linked to health issues, particularly if there are symptoms or a family history of stroke.
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Closure Recommendations: It's not uncommon for cardiologists to consider closing a PFO, particularly in individuals with recurrent strokes or significant symptoms that might be linked to the PFO. It tends to be more strongly considered if you have a history of strokes or transient ischemic attacks (TIAs).
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Factors Influencing Closure: Decisions on closure usually involve:
- Presence of symptoms (e.g. migraines, chest discomfort).
- Family history of stroke.
- Overall risk assessment including other medical conditions (like POTS). Your cardiologist will weigh these aspects carefully.
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Symptom Links: There is ongoing research about whether conditions like migraines and certain arrhythmias can be linked to a PFO. While your symptoms could be incidental or related to your POTS, discussing them further with your cardiologist is essential. Some people report improvement in migraines post-PFO closure, but results can vary.
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Expressing Your Concerns: It is completely valid to communicate your worries about your health and the PFO's implications, especially considering your family history. Be open with your cardiologist about your symptoms and your father's stroke incident; this information is crucial.
Next Steps:
- Document Your Symptoms: Keep a detailed symptom diary leading up to your appointment. Note any patterns, severity, and frequency of migraines, fatigue, and chest discomfort.
- Prepare Questions for Your Cardiologist: Create a list of questions including your desire for PFO closure and how your symptoms might relate to it. Bring up your family history of stroke and its impact on your concerns.
- Lifestyle Modifications: Continue managing your POTS and related symptoms as advised by your healthcare provider, and consider lifestyle changes that support cardiovascular health, such as hydration, balanced nutrition, and stress management techniques.
You are taking an important step by seeking clarification about your health. Continue to advocate for yourself as you engage with your cardiologist, ensuring all your concerns are addressed. Take care, and I wish you the best in your upcoming discussions!
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