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Question:
Have you ever heard of a micro-PFO?
I have been having neurological symptoms for about a month -- tingling in hands/feet and headaches.The neurologist sent me to a cardiologist who looked for a PFO [patent foramen ovale]. The bubble test showed the bubbles cross over to the other chamber. However, a TEE didn't indicate a hole. My cardiologist says I may have a micro-PFO, so tiny that the TEE didn't pick up. Could this be possible? The cardiologist recommends taking an aspirin a day and believes the neurological symptoms are due to something else, perhaps migraines. Have you ever heard of a micro-PFO?
submitted by Anthony from Syracuse, New York on 10/22/09
Answer:
by Texas Heart Institute cardiologist, George Younis, MD
It is quite common to be unable to visualize a PFO [patent foramen ovale] on a TEE [transesophageal echocardiogram], partially because PFO are very small but also partially because the anatomy of PFO can be rather complicated and not easily seen by any imaging modality. That is why we typically use a bubble study as a surrogate for being able to actually see these PFOs. If the bubbles cross over in a way that is consistent with PFO, that is enough for the diagnosis. I don't think it's likely that your PFO has anything to do with your neurological symptoms. Taking an aspirin is reasonable. At this time, the current management for PFO in patients without history of stroke is simply to consider aspirin therapy.
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Updated October 2009
