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Suggest Treatment For Patent Foramen Ovale

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Posted on Mon, 30 Mar 2015
Question: I found out about a year ago that I have patent foramen ovale. I am now 67. I went to the hospital because I had shortness of breath and a feeling of congestion in my jaw. They did quite a few tests - blood test for heart attack every hour for 24 hours, ekgs, and finally a stress echocardiagram. The one thing the found was the PFO. About 10 years before that I thought I was having a heart attack and I went to emergency room. They didn't find anything, but did send me for a cardiology follow up. In this study doing an echo with XXXXXXX the one thing they found was a slight mitral valve "floppiness", but nothing to be concerned about. Going back even further, when I was 42 I had a TIA which included complete paralysis of my left arm and numbness and lack of coordination with my left leg. I was in the hospital for a week (the paralaysis) only lasted about 4 hours. They did CT scan, ultrasound and lots of watching me, blood tests, etc. They could never figure out why I had the TIA. At the time I had low blood pressure, good cholesterol levels with a great HDL to LDL ration. No apparent reason for the TIA. But I did have a history of migraines, so the final report said that it was a migraine. One other theory was that I had a temporary muscle spasm of the carotid artery, but there was not actual proof. They put me on a calcium channel blocker and one aspirin a day. I am not sure why, but within a few years they stopped the calcium channel blocker. After menopause at the age of 56 I developed moderately high blood pressure - 140-150/ over 70 or 80. Although often it is in the 120 over 60 range. I take 10 milligrams of Lisinopril daily. I also have a history of sinus problems and I have been using a SUAD device for sleep apnea for about 7 years. (Oral device that pushes my lower jaw out and opens the air passage) I have never used a CPAP. I fall asleep watching tv and reading, but have no trouble staying awake when working, driving, etc. I do feel tired and slightly out of breath doing things that did not make me tired a few years ago. I am overweight 148 lbs and 5' 2' - more weight in my hips, thighs, legs than abdomen. Finally, I get heart palpitations, but not severe. I make them stop by coughing. I feel a bit like a hypochondriac because I am very aware of all my symptoms, but I try to ignore them. For the last 40 years I have had ocassional tingling of hands, but usually only lasts minutes and doesn't happen often. Lately, I am having the palpitations more often. I also sometimes hear my heartbeat in my head/ear and sometimes when I am in bed I can feel my heart beat in my chest - like it is sort of popping out. This does not happen often. What is making me write today is that after spending a delightful day with old friends from college, I was driving home and I got the weirdest sensation in my head. I don't quite know how to describe it - sort of like a rushing of blood that came in waves. I tried deep breathing but I think that made it worse. I opened my car window in case there was some sort of exhaust leaking in. I think that helped a little. We did eat quite a bit that afternoon and had about 3 glasses of wine over 7 hours. Also had cake with frosting and strong coffee. I drink coffee every day so that was not something different for me. I wish I could describe the sensation in my head - not light-headed really, more like a feeling of something filling my head in a rush and then fading away. It happened like that for about 30 minutes. I was able to think, concentrate, etc. I did not feel panicked. I have never had a panic attack or anything like that. Is that what one feels like? Or could all of this somehow relate to the PFO?
I forgot to say that I was treated for hypothyroidism from the age of 24 to 37. I took synthroid. At 37, an endocrinologist said I did not need to be treated and maybe never had needed it. I have many of the "Classic symptoms" of hypothyroidism - lack of energy, thinning hair, no underarm hair, minmal eyebrows, no hair on arms and legs, but my T3 and T4 tests are normal.
doctor
Answered by Dr. Lilit Baghdasaryan (5 hours later)
Brief Answer:
Psychogenic cause is possible

Detailed Answer:
Dear Mrs,

I went carefully through your history and understand your concerns.
From your description it seems that your complaints are psyciological.
The complications of PFO are caused by small thrombi, traveling from the heart to brain. They can cause TIA or migrain. It is not common for them to cause such symptoms.
I would advise you to consult with neurologist and psychiatrist. In this case EEG can be helpful as well.
But there is possibility that it was something accidental with psychogenic origin and will never happen again.

Hope I could help you

Wishing you good health

In case of further questions don't hesitate to ask

Regards,
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Lilit Baghdasaryan

Cardiologist

Practicing since :2007

Answered : 1536 Questions

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Suggest Treatment For Patent Foramen Ovale

Brief Answer: Psychogenic cause is possible Detailed Answer: Dear Mrs, I went carefully through your history and understand your concerns. From your description it seems that your complaints are psyciological. The complications of PFO are caused by small thrombi, traveling from the heart to brain. They can cause TIA or migrain. It is not common for them to cause such symptoms. I would advise you to consult with neurologist and psychiatrist. In this case EEG can be helpful as well. But there is possibility that it was something accidental with psychogenic origin and will never happen again. Hope I could help you Wishing you good health In case of further questions don't hesitate to ask Regards,