"Probable TIA's"; multiple cardiac symptoms and apparent lack of treatment options??

[julie77736]

Hello,
I am very anxious about the recent results of my Echocardiogram's and my transcranial doppler bubble study, and the apparent lack of options for my condition.
I have had many signs and symptoms recently that were very "typical" for heart disease.I have also had several events that were "probable TIA's".
After very thorough testing they diagnosed:
1) PFO with right to left shunt and micro-bubbles when doing the valsalva manuever - but not at rest -  rated grade 2/5.
2) Moderate mitral valve regurgitation with moderate left atrium enlargement.
My Nuclear med stress test and carotid ultrasound were both 'normal'; my holter showed frequent PVC's but otherwise was normal.

Apparently I am to continue with my usual regimen (meds for hypertension, daily aspirin and med for high cholesterol) and that is all they can offer - but I have been on these meds for many years - and they did not prevent the TIA's and all the other symptoms that I have had recently. I am very worried about the possibility of a major stroke and/or another heart issue. I just turned 50 years old. I do not smoke or drink; I have eliminated almost all caffeine and have greatly decreased the fat in my diet (now eating a lot of fresh fruits/veggies per day, etc.). I am a little overweight and have had high BP since the birth of my first child - but it is very well controlled.In the past there were many CVA's on both sides of my family, but not as many in recent generations.
I am so scared!!! My husband and I have full custody of our 6 year old grandson and I am worried about him  if anything were to happen to me. :(
I have a very physically and emotionally stressful job (RN on a Oncology floor). I LOVE my job and my patients, but am certain it is making this worse; do I need to quit???

I will be thankful for any and all suggestions or thoughts.
Thanks

[julie77736]

?? Hello??
Anyone have an answer/ideas for me??
See original post "probable TIA's, multiple cardiac problems and apparent lack of treatment options?"
Thanks  ;)

[julie77736]

ed34 -
Thank you very much for your reply and kind words, it helps! :)

Apparently they believe that with this PFO and the right to left shunt, there may be microemboli, or small clots being thrown from my heart, and that is causing the TIA's. I am still not totally sure - I see the Neurologist again tomorrow and I sure hope he has some good answers!
Also, something about the blood being stagnant at times, which usually leads to a higher incidence of clotting. You see I have blood hitting my left atrium from "3" different areas instead of the normal "1" (blood comes in from the lungs, reoxygenated - thats normal; but I also have regurgitation of blood from below - from the abnormal mitral valve and now I have blood coming from the right - with the positive test showing "right to left shunt" when the PFO was tested). I think the blood in my left atrium is swirling around like a whirlpool and so at times there must be some stagnancy or 'delay' - this leads to clot. Boy, I am also thinking my left atrium is taking a beating and blood may be shunting back into my lung (pulmonary hypertension ??)
I feel like such a "Whiner" here ..... yah, as an oncology nurse I have seen some really bad stuff .... and my patients have blessed me and helped me to appreciate the health that I have! But my grandson NEEDS me and I need him! My Neurologist said that the newest evidence supports NOT surgically correcting the PFO (apparently there is not enough evidence proving it helps in any way to close it; plus there have been many problems after having the procedure(s).
I think I am seeing the very best of the best - at least in WA state. I have seen 2 cardiologists recently - the first one was very vague and I needed more answers, so I returned to a highly respected cardiologist I saw years ago in Seattle - she was very helpful and answered my many questions regarding the mitral valve - this 2nd cardiologist also stated I needed to see a Neurologist ASAP, as many of my symptoms were like TIA's and she noticed the PFO on my echo (the first cardiologist didn't mention this at all). The Neuro I saw I have been seeing off and on for many years for another issue (A very long story that they have never quite figured out .... boy, I am an enigma!) Anyway, he is an excellent and well respected Neurologist; he has sent me to many different Neurologists throughout the state and he always reminds me that he will get me an appointment at the Mayo clinic if I want, etc. etc. He has really helped my condition with medications and treatments, but always reminds me "you are too young for an autopsy!" -He has suspected I have MS with silent lesions (lesions not clear on MRI, but can be found at autopsy) Anyway, it is a huge story and I have been given so many different 'possible' diagnoses over the years - but I really trust this doctor, he is great..... BUT he does not specialize in strokes, he is more of a general neurologist ..... that's a good thought Ed, I should get another neurologists opinion; I am sure he will offer me this at my appointment.
Thanks for allowing me to vent - I feel better. If anyone has any ideas about this please share! :)