Possible TIA ?

[sdear]

About 2 weeks ago I had an episode while shopping in Wal Mart.  It was like the lights went out completely, came back on , went back off , then back on.  Happened very quickly.  After that, I felt light headed, dizzy, and a little tightness in my chest.  Arms felt kind of tingly, then it all passed.  I wrote it off to stress.   I went to see my doc for a reg scheduled appointment and told him of the incident.  He ordered an echo which showed small amount of mitral regurg, tricuspid regurg, and a small PFO.   All other functions were good.   I saw a cardiologist yesterday, and he has ordered a stress test, and wants me to see a neurologist to give an opinion on whether he feels that incident was a TIA.  He said if it is a TIA, it could be caused from the PFO .  Is one incident enough to make that evaluation?  

I am 46 years old and also am on tamoxifen for lobular neoplasia.  Would it be a good idea to be on blood thinners now that I know of this PFO since this is a risk for clots as well as tamoxifen?   I guess I am just trying to jump ahead of these tests and the waiting.  I am taking a baby aspirin every day, but I read that that isn't that good at protecting from problems with PFO's.  

Thanks for any input.  

Sue

[sdear]

Thanks Doc...I appreciate your input.  I am thinking coumadin will be necessary if I plan on staying on Tamoxifen.  


Wmac...I don't really recall.  I do remember an overwhelming dizziness...not like the kind when you turn your head to fast etc.   I was walking straight ahead...and boom, the lights went out, on, out, and on again.  I was dizzy, and felt some chest tightness shortly after.   I felt a little tingly in my arms as well.    It happened very fast, and I was able to check out and go home...but i just didnt feel good the rest of the day.

[wmac]

Hello, I read your post. My question to you is that did it feel kinda like a whip lash experince like your head was slamed forward and then backwards? I get this often and I never pass out it just happens really quick, forward and backwards and everything goes black.Thanks
wmac

[CCF-M.D.-MJM]

Sdear,

Sorry to here about the incident.  IT is going to hard to tell whether this was really a TIA or not.  It will come down to the neurologist making an informed opinion and then directing care based on that. It is true that tamoxifen and a carcinoma are risk factors for clots.  Normally the clots would be absorbed in the lung and small ones would not cause symptoms.  With a PFO (patent foremen ovale), the clots that would normally go the lung can pass from the right side to the left side of the heart and cause a transient ischemic attach (TIA) or stroke.

If the suspicion is high that this is a TIA, you should be on coumadin if there are no other contraindications.  Until you see the neurologist, aspirin is fine, although you should see the neurologist soon.

Hope this helps and happy holidays.