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Pediatric Heart (Expert Forum)
pulmonary stenosis & migraines
Answered by
Jeffrey R Boris, M.D. - Pediatric Cardiology, Ambulatory Cardiology
The Children’s Hospital of Philadelphia
Philadelphia - PA
Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.
pulmonary stenosis & migraines
by kearneytink, Oct 11, 2009 05:02PM
my grandaughter is 9 yrs. old she was dignosed with pulmonary stenosis at age one. She has migraine headaches with voiming since age 2yrs. old. Her headaches are getting worse and more often. Could this be related to the heart valve. Her cardoligest said she was to young for migraines. He does not seem concerned. She is seen by him every 2yrs. I think it could be related. please help
Doctor's Answer
by Jeffrey R Boris, M.D., Oct 12, 2009 01:39PM
, Oct 12, 2009 01:39PMTo: kearneytink
Dear Kearneytink,
Overall, I do not believe that your granddaughter’s headaches are associated with her pulmonary stenosis. There is no support for this in the medical literature. Pulmonary stenosis is obstruction at, below, or above the pulmonary valve. Blood goes beyond the valve into the lungs, and then to the left side of the heart. The only possible congenital cardiac defect that may be associated with migraine is the presence of a patent foramen ovale, which is the persistently open connection between the upper two chambers of the heart that all babies have while in utero. This typically closes in the first year after birth, although up to 25-30% of all adults have it remain open (but not nearly that many of the general population have migraine or recurrent headaches). The literature hasn’t completely confirmed this association, yet, though.
In all of this, you do not mention the severity of your granddaughter’s pulmonary stenosis. It can be trivial, mild, moderate, or severe. If it is moderate or severe, it likely requires some sort of intervention. Howvever, more likely, based on your cardiologist seeing her every 2 years, it is trivial or mild, which should not cause any other cardiac problems.
Finally, migraine is a very specific kind of headache that has specific clinical history and findings. And, despite your cardiologist’s statement, it can occur in children. However, I would check with your granddaughter’s primary care provider to get a specific diagnosis. If that provider is not able to help, then evaluation by a pediatric neurologist may be indicated.
Overall, I do not believe that your granddaughter’s headaches are associated with her pulmonary stenosis. There is no support for this in the medical literature. Pulmonary stenosis is obstruction at, below, or above the pulmonary valve. Blood goes beyond the valve into the lungs, and then to the left side of the heart. The only possible congenital cardiac defect that may be associated with migraine is the presence of a patent foramen ovale, which is the persistently open connection between the upper two chambers of the heart that all babies have while in utero. This typically closes in the first year after birth, although up to 25-30% of all adults have it remain open (but not nearly that many of the general population have migraine or recurrent headaches). The literature hasn’t completely confirmed this association, yet, though.
In all of this, you do not mention the severity of your granddaughter’s pulmonary stenosis. It can be trivial, mild, moderate, or severe. If it is moderate or severe, it likely requires some sort of intervention. Howvever, more likely, based on your cardiologist seeing her every 2 years, it is trivial or mild, which should not cause any other cardiac problems.
Finally, migraine is a very specific kind of headache that has specific clinical history and findings. And, despite your cardiologist’s statement, it can occur in children. However, I would check with your granddaughter’s primary care provider to get a specific diagnosis. If that provider is not able to help, then evaluation by a pediatric neurologist may be indicated.
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