Depending on the size of the PFO, it may be able to be closed percutaneously ( with a catheter). Given your symptoms, and presence of right to left shunt with a suspected embolic event, you should undergo closure of the PFO, in order to prevent a CVA or TIA recurrence.
If the percutaneous procedure is not available in your area we have a cardiac specialist in our division which has extensive experience in the percutaneous closure of these PFOs and also ASDs ( which yours is more likely to be given it size). His name is Dr. Rich Krasuski and his office number is (216) 445-7430. If you are interested in his opinion, or the procedure, give his office a call for an appointment.
Thank you for your response. I need to ask the cardiologist performing the TEE (who would also perform the closure if I stay with her) about the size and location of the defect. She did not talk to me after the TEE, and I don't know if she wants to see me again before the surgery. She scheduled the closure surgery for the 29th of January (scheduled before she performed the TEE), which I found a little "different". I may not stay with that date. I would be worried about a right-to-left shunting ASD, and the potential for pulmonary hypertension. The TCD indicated a right-to-left atrial septum/pulmonary shunt, but I don't know if that's just the terminology they use.
I also have weird symptoms of difficulty taking a deep breath at times, and difficulty getting a yawn out. My lipids are normal, my LVEF is 75%, my BP is around 96/54 and my resting HR is in the 40's. The only other oddities I feel are my exercise HR sometimes is way higher than what is warranted given my conditioning and the level of exertion when it is high.. meaning it can go well into the 180's and stay there and I am not breathing hard. Additionally, it will sometimes shoot up drastically in the beginning of exertion after warmup, and then seems to settle down a bit. I have been told these are nothing to worry about, that everyone is different... so I don't think about it too often.
I live in a major metro area with a top research hospital, yet I may end up calling Dr. Krasuski since I believe Cleveland Clinic is superb in cardiovascular care :)
Thank you very much for your time and this service.
I am dealing with something similar to you---except I am 59, managing a mild AAA, and out of the blue--my last ECHO, comes up with a possible PFO/ASD and raised pressures in RA---possible Pulmonary Hypertension (IVC failed to collapse). I am also a jogger/runner---over 30 years. In any event, I live in NYC so there are hospitals here that deal with this.
I have no symptoms, taking a bubble ECHO next week and possible TEE right after. I am also having a Chest CAT to check for any pulmonary emboli. If what i undertand is so, i would be electing to close the PFO or ASD pretty soon in order to reverse or stablisze any further pulmonary hypertension. Did your ECHO have any evidence of PH or right side heart enlargment? I ask because l am trying to undertand this thing. Best of luck to you--with today's "medicine" we should be fine!
I'm not 100% sure what mild AAA is? I am sorry you are dealing with possible pulmonary hypertension. That's a tough deal. I live on the opposite coast of you.. in the San Francisco Bay Area. We coasties have it made :). Good luck on the bubble test and possible TEE. The TEE is relatively easy... and I hate having things stuck down my throat. You won't even know it happened. I was awake at the end of the test (and during I guess) and don't even remember them talking to my hubby! The original echo didn't say anything about PH, yet I don't believe the doc checked right sided heart "stuff" very thoroughly. I only see measurements of Left side. I think he was skeptical of why I was there. He had talked about doing a tilt table test despite my telling him dizziness wasn't positional. So, I don't think he knew what to do. I saw a neuro after who got me going in the right direction. I do not know the results of my TEE, other than they told my hubby there was a hole that a lot a lot of flow right to left even during sedated respiration. So, the flap must be very patent because a strain isn't necessary to open it up. . That is in line with what the bubble test showed too. They also said I have a very very small heart I do wonder about right sided heart pressure, because from what I understand, the flow thru a PFO should only happen during moments when the right sided pressure is higher than left sided pressure. I know I have cases of left sided chest pressure (thus the right side of my heart) so I wonder what's going on. I would hope they want to check the pressures between right and left before doing any closure, so I am going to call the cardiologist on Tuesday that performed the TEE.
Best of luck to you on your tests. Since you are not symptomatic that should be somewhat reassuring to you. Please post to let me know how things went.