I was recently diagnosed with a PFO as well as an ASA with right to left shunting.. I'm just wondering what the difference is between the two.. From what I've read they seem pretty similar, is that correct?? I was told to take a baby aspirin a day and to come back every two to three year for echos.
BTW, I also have a bicuspid aortic valve that was found at the same time as the PFO and ASA. I've also had two ablations for PVCs, the first was unsuccessful, the second was was a success and I'm PVC free for the first time in my life. (I was having between 12 and 15 thousand PVCs a day.) I'm 28, not over weight, don't smoke and generally in good health other than the new found heart issues.. I do have chronic daily headache with break through migraine w/aura.. How concerned should I be with stroke??
No. A PFO is a congenital remnant, which if present in a normal patient normally causes a left to right shunting. If you have one and there is right to left shunting then you may already be feeling the long term effects of this process which can be to cause right ventricular systolic dysfunction and dilatation. What is the status of your right ventricle on the echocardiogram? With a right to left shunt an Aspirin is usually recommended for stroke prevention. There is also some data linking the closure of these PFOs and decrease in migraine burden.
An ASA is an aneurysm, that is an out pouching of the wall between the two atria. There is no flow here, but becasue of this process can cause clots to form and embolize anticoagulation with aspirin or coumadin is sometimes recommended.
I worry more about the bicuspid valve which can degenerate and cause severe stenosis in your 50s and regurgitation in your 40s. This alone should mandate close ( every two or three year )n echos.
The paper they gave me with the results of my echo say "Aneurysm Atrial Septal Wall: With shunting. Bicuspid Aortic Valve:No significant valvular dysfunction on echo. Aortic root 3.5 cm."
On another page are the doctors notes and it says "An echocardiogram was performed, demonstrated normal LV systolic function with upper limit of normal LV chamber size, ASA with shunting seen across septum. Bicuspid aortic valve." Also goes on to say "Premature Ventricular Contractions:Frequent ventricular ectopy with upper limit of normal/mildly enlarged LV size that may be due to PVC burden. Location suggestive of inferior RV septum no typical." and then it goes on to discuss plans for ablation which I have done already. I do know they said it was a right to left shut, but I can't seem to find that on the paper work they gave me.
At this point, what they have told me is that the BAV looks good so far, but I will probably need to have it replaced at some point in my life. They want to keep my heart as healthy as possible for as long as possible so we can put off the surgery for as long as we can, they said hopefully 30+ years. They felt that the amount of PVCs I was having was contributing to the enlarging of the LV (which I know you just read) and that's why they wanted to ablate. They really haven't focused on the PFO or ASA at all except to say they were there and to take a baby aspirin daily. They aren't at all concerned with closing it.
I have had episodes of PSVT since the ablation and my heart is very "excitable", will jump up into the 120s and higher (have seen it as high as 170) just doing normal everyday activities, like cleaning etc, but I was told that should start to go away as I get further away from the ablation. My last ablation was in March though and I'm still getting the SVT, so I'm not sure if that's something I should be concerned with, if it should have gone away by now. I did try donating blood the other day and I was turned away because we couldn't get my pulse below 116, he said it needed to be below 100 to donate and seemed concerned that 116 was pretty normal for me as of late.
It does seem that you would agree with what they have told me. The PFO/ASA aren't that big of a concern, and it's the BAV that we need to watch closely. Is that correct?? What do you think of the high heart rate? Is that something that I should bring back to the attention of my cardiologist? Thanks for all the info. This is all so new to me!!
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