question about detecting PFO's

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salgal01
New Member


Date Joined Jan 2009
Total Posts : 2
   Posted 1/9/2009 3:16 PM (GMT -7)   
I have been reading this board for awhile now, gathering information because my 21 year old daughter has suffered from migraine headaches since first grade(now in her third year of college).  We've been to pediatricians, neurologists, general internists, massage therapists, orthodontists and now to a headache center.  It seems that we never  really get significant relief( she has a bad headache at least once a week). At her Dec. visit to the headhache center, however, the neurologist noticed a rapid heart rate and high blood pressure.  We were immediately sent to the cardiologist who ran an EKG, bloodwork, and an echocardiogram along with his clinical exam.  Although, her vital numbers were a little high, he seemed to brush it off.  Her echo and bloodwork showed nothing.  I was wondering if a PFO would have shown up on the echo?  Did others with PFO's have symptoms?  She is on Zanaflex, Cymbalta and Inderal (prescribed by the cardiologist).  I actually think that I have noticed an improvement since she started the Inderal.  I also am trying to get used to the fact that she is only 21 and on so much medicine although I don't want her having the headaches, either.  I was wondering if the normal echo would rule out the possibility that a PFO could have been causing the headaches all of these years?

CatMom5
Regular Member


Date Joined Apr 2008
Total Posts : 88
   Posted 1/10/2009 2:14 PM (GMT -7)   
salgal, I'm sorry your daughter is suffering so. I started having migraines when I was 8 or 9. Right before I started low carbing 6 years ago I was having 3-4 migraines a week. Going low carb really helped me and my instances of migraines went down to 2 -3 a month. I was very happy with that outcome until February of last year when out of the blue I had a mini-stroke. It was finally discovered that I had a PFO and ASA. I had every test done including an echo and they found nothing. It took a wonderful neurologist to insist that I have a TEE or transesophageal echocardiagram. That was how they found my PFO/ASA. I had my PFO closed last April. There really are only two ways that a PFO can be detected and that is by having a TEE or an echocardiagram with bubble study done. A plain echocardiagram cannot detect a PFO, you also must include the bubble study part. During the echo they give you an IV and during the test a nurse will force the IV into you at the same time that you are pushing down or straining. What happens is that send lots of bubbles through your heart and you can see the bubbles go from one side of your heart to the other side if you have a PFO or opening in the heart wall. No bubbles going accross equals no PFO.

So that was a long winded way to answer your question that no, a normal echo cannot detect a PFO. By the way, since my closure in April 2008 I have not had a single migraine.

salgal01
New Member


Date Joined Jan 2009
Total Posts : 2
   Posted 1/10/2009 5:49 PM (GMT -7)   

Your answer was not longwinded and very informative...Thank you so much for your thoughtful response.  I am so glad that you found your cause and now have relief!

I plan to follow up with her regular doctor her in town.  You've given such helpful information.  We travel to a well respected medical center a few hours from our home.  Like I said, our neurologist was concerned and could not get us to the cardiologist fast enough.  I was suprised when although her blood pressure, heart rate and EKG numbers were "a little high", especially for a 21 year old, that they weren't more concerned like the neurologist was.  I will see about having the echo that you described done here in town.  It certainly would answer a lot of questions and explain why we've had limited success all of these years with preventatives and relief.  I am so glad that your neurologist pushed forward and I think it is definitely worth looking into for us,too. Thanks again!


Olykate
Regular Member


Date Joined Jul 2005
Total Posts : 32
   Posted 1/11/2009 6:21 PM (GMT -7)   
Sorry to sound dumb but what are a PFO and ASA? I have migraines, am 39. This last weekend I went from weak in the legs all day and confused with weak speech to sky high blood pressure and serious shuddering for about 2 hours around 5pm, then it turned into a screaming migraine-which went away without medication.My doc says I may be having the mini stroke thing not migraines so have an appointment already with a neurologist this week. Had to wait 2 months for that. Funny how that works. My bloodpressure at one point was 187/143.
Kate

CatMom5
Regular Member


Date Joined Apr 2008
Total Posts : 88
   Posted 1/12/2009 11:44 AM (GMT -7)   
Hi Olykate. It's not a dumb question at all! A PFO or Patent Foramen Ovale is essentially a hole in the heart or flap between the Atrial chambers. If the flap opens due to straining, etc. it allows unfiltered blood to go from one chamber to the other and consequently through to your brain. If there happens to be a clot when the unfiltered blood gets through you could have a stroke. My cardiologist discribed my ASA or Atrial Septal Aneurism as a floppy or ballooning wall which happens to be the same wall that contains the PFO. There are many studies going on right now as there seems to be a correlation between migraines especially migraines with aura and PFOs. All I can tell you is that I had migraines from young childhood through my entire life. Last year I had a TIA or mini-stroke and was diagnosed with a PFO and ASA. I had my closure done last April and have not had a migraine since. I'm so sorry you are having such problems. I hope your Neurologist is able to determine what is happening for you and checks for a PFO. If they do an echocardiagram make sure they include the bubble study.
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