I recently underwent transcatheter PFO closure and experienced a great result in improved stamina and exercise tolerance. I then started having chest pain with exercise, but I have admittedly been exercising a lot and it seems things might be irritated. I have chest pain in my left chest followed by involuntary coughing. I saw my cardiologist for a follow up. The device appeared to be well-seated, but during the TTE with bubble study a large number of bubbles went through to the left heart on the 5th cardiac cycle. They used to go through immediately. Last year a different cardiologist and pulmonologist thought they heard a noisy PAVM (grade 4). A pulmonary CTA was performed and showed nothing more that nonspecific pleuritic abnormalities. I know it is possible to have microscopic PAVM. It is likely too small to treat if I have one. Do I need to follow up on this? The chest pain and coughing are annoying, but tolerable. I am not sure if there is value in investigating this further although I am a scuba diver and I have upcoming dental work. Any thoughts on what I should do next if anything would be appreciated. My ecg is normal with sinus tach. I have possible svt's - still waiting to catch those on a monitor.
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