Six weeks ago, I underwent a transcranial Doppler with microbubbles. There was no shunting at rest, but major right to left shunting during the Valsalva maneuver. The cardiologist was confident that I had a Patent Foramen Ovale. This morning I underwent a transesophageal echocardiogram. No PFO was found! The doctor was amazed. He will be sending me for more tests to find the "leak" but I have been disqualified from the medical study I was participating in. Any ideas where the shunting could be coming from? I thought I had a PFO and had nothing to worry about. Should I be worried now?
A PFO is only one of the many possible connections between the Right and left systems. You could have an AV fistula, or a pulmonary vein that empties to the right atrium. Hence a CT angiogram of the chest should give than answer in most patients, for why you are having microbubbles on a TCD during valsalve.
Another possibility is that you did not strain hard enough during the TEE because of sedation, so the shunting was never observed during that procedure. .
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.