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.
-
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).
-
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.
-
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.
-
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!
Related Questions
Could Globus Sensation Be Confused with Throat Cancer?
At 18 years old and having smoked for roughly 2 to 2.5 years, I've started to feel a strange tightness in my neck and noticed a small, movable lump on the left side near my lower jaw. Throughout the summer, I've been dealing with a persistent cough and occasional breathing issues, which I attribute to my smoking habits. Presently, I'm making efforts to quit smoking, but I notice my symptoms often worsen when I abstain for an extended period. Recently, I experienced a brief episode of tongue numbness, which heightened my anxiety. Though I can't pinpoint the cause, I constantly feel as if something is lodged in my throat. Initially, I believed this was due to my prominent Adam's apple, but I'm uncertain. Despite this uncomfortable sensation, I've not encountered any trouble with drinking or swallowing, which makes the experience even more puzzling. I'm seeking insights into what might be causing these feelings. Any feedback or suggestions would be greatly valued!
Should I Be Concerned About Bright Green Stool?
At 21 years of age and assigned female at birth, I've experienced a peculiar gastrointestinal issue for the past two days involving stool that is an intense, vibrant green. While I've read that some green stools can be typical, this particular shade resembles something straight out of a paint swatch—almost like candy! I understand that green stool can indicate that food passed through the digestive tract too quickly. However, considering I’ve been experiencing slight constipation lately and haven't had many bowel movements, this explanation doesn't fit my situation. I'm also feeling unusually bloated, adding to my apprehension. A couple of days ago, I took an excessive dose of Benadryl (a decision I won't repeat) and I'm currently on Lexapro. Additionally, I've recently incorporated new multivitamin gummies into my routine. Generally, my bowel movements aren't affected much by food dyes, as I only notice greenish stool perhaps once a year. Thus, I find it difficult to attribute this change solely to dietary factors. Should I be worried about these symptoms, or am I perhaps overreacting?
Post-Surgery Complications: My Experience with Septoplasty, Sinusectomy, and Turbinectomy
In 2022, I visited an ear, nose, and throat specialist to address some sinusitis issues, and during that appointment, he recommended surgery for a deviated septum. While my breathing was manageable, I suspect he may have had financial incentives related to my health insurance, a realization that dawned on me only after the procedure. This occurred in October of that year. Fast forward two months to early 2023, and I found myself at the hospital, ready for surgery. As I was signing the necessary paperwork, I discovered that I was also set to undergo a sinusectomy and a turbinectomy, neither of which had been mentioned to me previously. It was rather unsettling when an accompanying staff member made a remark just before I lost consciousness from the anesthesia, saying, "It’s going to get cold in here." Weeks into my recovery, I noticed something felt off. My vocal coach advised me to apply hydrogen peroxide in my nostrils, which resulted in a burning sensation not only in my nostrils but also at the base of my brain, leading to significant pain and a wave of sickness thereafter. It left me wondering if there was a leak somewhere between my nostrils and my brain, a terrifying thought given the situation. I felt remarkably unfortunate, as this combination of events could imply either a cerebrospinal fluid (CSF) leak or a perforation threatening my brain. Sometimes I experience dizziness, and when I lay down to administer saline solution into my nostrils, I can strangely sense it reaching the base of my head, providing momentary relief despite being a bizarre sensation. Nevertheless, my overall well-being is declining; I’ve been experiencing persistent tinnitus and a growing sense of disconnection from reality. I underwent several tests, and the outcomes have been puzzling, as noted in some images I had taken. Many doctors I consulted offered little insight regarding the results. Living in Brazil presents challenges in medical care, especially for conditions like mine—most local physicians seem focused on treating trivial ailments such as mild colds or allergies. From what I could infer, the sinusectomy was performed on the right side of my nose. Additionally, at the conclusion of 2023, I visited a different ear, nose, and throat specialist who, during a check-up, extracted a large bone fragment from my right nostril. Its cartilage was thin and approximately the length of my thumb, which unfortunately worsened my breathing post-removal. I can’t help but wonder if the surgeon utilized this cartilage for reconstruction or repair during the initial operation. It seems to me that the base of my skull might be compromised, particularly the bone extending from the spine to the brain, especially in the area adjacent to my nostrils. I could really use some guidance on this matter. I’m 173 cm tall and weigh about 68 kg. Early in 2024, I experienced a head injury when I was assaulted during an attempted robbery; I’m uncertain if this could be affecting my situation now. At the start of the year, I was also diagnosed with mild degeneration of the intervertebral disk at the C5-C6 level, and I ponder whether this is related to my post-operative complications. There are times when my nostrils emit an unpleasant odor during breathing, particularly noticeable when I irrigate them with saline solution, especially from the right side. I would appreciate any insights regarding what I might be facing.
Black Spot Observed on Tonsil
A 29-year-old female currently taking Lexapro and semaglutide has noticed a small black dot on her tonsil. This individual frequently inspects her tonsils due to recurring tonsil stones. The black spot is persistent and does not come off when she attempts to clean it with a cotton swab. Additionally, she has previously consulted a physician about another spot on her tonsil, marked in red. The doctor suggested it might be a ruptured blood vessel, although there are concerns since this spot appears to be enlarging. Furthermore, she underwent an oral cancer screening within the past year, which returned normal results.
Recovering from Covid: Understanding My Symptoms Post-Medication
I am a 46-year-old Caucasian male, standing at 6'1" and weighing 152 pounds. I live in the USA, don’t smoke, avoid drugs, and follow a vegan diet. Recently, after experiencing prolonged illness, I took two at-home tests for Covid that yielded negative results. However, a subsequent visit to urgent care, initially intended for what I suspected to be a sinus infection, surprisingly confirmed I was positive for Covid. The physician recommended a treatment plan that included Paxlovid and a five-day regimen of Dexamethasone, which I finished two days ago. Although my latest home test returned negative, I'm still feeling unwell and would like to share my current symptoms for clarity: - Persistent fatigue and a sense of sluggishness; I’m battling brain fog and an overall feeling of disconnection. - My stomach is excessively bloated and uncomfortable, primarily feeling gassy and sensitive. As a result, I've switched to a bland diet similar to the BRAT diet. - Despite not consuming as much as usual, I have inexplicably gained around four pounds. - I’ve noticed a reduced ability to taste and smell. - There’s noticeable soreness in my muscles, especially around my hips and legs. I attempted to exercise, but my body struggled with the demands, particularly while running on the treadmill. (For context, I typically maintain a high level of fitness and physical activity.) While I was on Dexamethasone, my sleep was significantly affected. I’m unsure whether the symptoms I’m experiencing are linked to lingering effects of Covid or to the medications I’ve taken. I would appreciate any suggestions or advice on how I might enhance my recovery. Thank you for your assistance!