closure of Patent foreman ovale/ running and lifting weights

[Terry]

A few months ago I was suffering from a Migrane headache.  I have had these headaches for years.  I usually experience blurred vision moving from the left eye to the right that usually last for approximately one hour followed by a headache that can last up to couple of days, this headache was different, the blurred vision was in both eyes and only lasted about 10 minutes.
    I was lifting weights the next day(36 hours following the blurred vision).  I went home and experienced what my doctors referred to as a TIA. My right arm went numb, I became dizzy, and had difficulty speaking.  The TIA lasted about 30 seconds.
     I visited my doctor and he ordered a MRI and a echo.  My MRI came back negative, however the echo showed that I had a PFO.
I visited with the Cardiologist and was informed that I would need a TEE and that if there were no clots behind my heart she would consider that I have the PFO closed by cath., if there were clots, she would put me on blood thinner. After the TEE, The cardiologist informed me that the PFO was smaller than first expected.  She recommened that I take an aspirin daily and come back and see her in 6 months.  I asked her about working out ( I usually run 15-18 miles per week, and lift weights) she said that I could do all activities.
     My wife works for a local cardio-vascular surgeon, I went to see him for a second opinion.  I became worried because he had a differnt view than the cardiologist.  He said because of my age (35) and activities he strongly recommends that I have the PFO closed. He also mentioned that I should cut back on working out.I also have experienced a difficult time trying to find anybody in Texas who even does the procedure.  I have heard of many different grafts (angel wings, cardioseal, star-flex).
    I would appreciate it if you would give me your opinion on the following:

1.  Do you recommend closing the PFO,take a blood thinner, or
    stay on one aspirin per day?

2.  Which graft has the best performance?

3.  Can I continue to run and lift weights?


Thank You

Terry Hagler

[Cleveland Clinic, MD]

Your case demonstrates the controversy that exists over the treatment of PFO and you can find many similar postings on this site.  There is an increased risk of stroke in persons with PFO and right to left shunting.  However this risk is still small - in the neighborhood of 1-2 %.  My personal bias is to close even small PFOs if there is a right to left shunt.  For PFOs without right to left shunt aspirin is probably adequate.  The new catheter closure devices make the decision easier as surgery can be avoided.  We are using the Rashkind device here a lot but different centers have different preferences.  As far as specific activities and limitations this is between you and your doctor.  If you would like to be evaluated here you may call the number below to make an appointment with Dr. Latson in the congenital heart disease clinic.

[tracey]

Terry
I too suffer from migraine headaches in which I get an aura followed by a loss of my peripheral vision.  This usually lasts about 30 minutes and it is followed by a terrible headache.  Tylenol has always relieved these ( I have had about 7 or 8 over the last 6 years).  In July of this year I had one which had the same symptoms but when I awoke the next morning I had some vision in my left eye which did not return.  After several tests (MRI with contrast and a flourecien angiorgram, blood work,) they concluded that I had a Migraneous stroke which caused lack of oxegan to that area in the eye, tus the vision loss.  I too have a PFO which was just diagnosed 2 years ago. I had a regular echocardiagram and was put on an aspirin a day also.  I saw a cardiologist at Massachusetts General Hospital (supposed to be one of the best in the world) and he said that he would not reccommend closure given my age (37)  and the fact that they had no evidence that this is what caused my attack.  Also he said that it is a risk in itself because you have to be on  heavy dosages of blood thinner afterwards to keep clots from forming on the closure device and also over time the device breaks down and then you run the risk of having a piece of it cause a blockage.   He also told me that there are not many of these done at this hospital because it is a fairly new procedure!  He urged me to excersize daily.  I don't know????  Who do you believe?  Sometimes I think the more opinions you get the more confused you become!!   good luck e-mail me, PLEASE if you hear anything else that could be of help, our situations are somewhat similar.
take care
tracey

***@****

[Cleveland Clinic, MD]

Thanks for your comments.

[waterlady85]

A related discussion, patent foreman was started.