Patent Ferimone Ovale (PFO) and Atrial Septal Aneurysm

[robbiecriss]

After many years of benign arryhthmias (regular PVCs and PACs with occasional bigeminy and ten or so short runs of pvcs in ten years), my cardiologist through an advanced echocardiagram found I had a small PFO and Atrial Septal Aneurysm with the least dangerous shunt. I am 48 years old, a runner and my blood work is excellent with high hdl, normal ldl and very low triglycerides. I am normal height and weight with only one grandfather who died of heart problems. He was a smoker and I am not.
     1. My cardiologist said there was nothing I could do to reverse or change my heart condition and I should come back every year or two in the absence of other symptoms to make sure the shunt had not changed. He said I would know the condition worsened if I had some kind of mini-stroke which obviously did not encourage me. Is this totally accurate or can you give me other advice?
     2. He always said in the absence of structural heart problems the arryhthmias were by definition benign and now with this find I am wondering if my "structural" heart problems are cause for concern with the arryhthmias? Specifically, if I have a non-sustained Vtac episode for say 15-30 seconds are my chances of sudden death increased with this type of structural situation?
    Just for your information, I take 180mg of cardizem daily and a baby aspirin. Blood pressure is normal to high normal depending on stress levels.
    Thanks in advance for any insight you can give me and finally would you recommend a second opinion? I like my cardiologist and think he is one of the best in our area

[dozerguy]

A related discussion, Atrial, aneurysm was started.

[robbiecriss]

I appreciate the encouragement and the fact that I have a PFO does not particularly bother me. What bothers me is the combination of the PFO and the Atrial Septal Aneurysm. I don't hear much about this problem but have read that the combination of the two increases markedly the chances of a stroke. Any comments on this?

[EchoTech]

Think of it this way- there are roughly 260 million people in America and 65 million have what you have.  it's not that big of a deal.  The fact that you run makes in extremely improbable that you would have a clot in the first place.  I don't have anything to add for the second part of the question.

[CCF-M.D.-MJM]

Hi Robbie,

This is a very common problem, in fact, 25% of the general population has a patent foramen ovale (PFO).

1. My cardiologist said there was nothing I could do to reverse or change my heart condition and I should come back every year or two in the absence of other symptoms to make sure the shunt had not changed. He said I would know the condition worsened if I had some kind of mini-stroke which obviously did not encourage me. Is this totally accurate or can you give me other advice?

This is pretty accurate.  Short of having an emobolic event or ministroke, it is difficult to justify closing it.  Even with your PACs/PVCs, closing the the PFO is unlikely to help.

2. He always said in the absence of structural heart problems the arryhthmias were by definition benign and now with this find I am wondering if my "structural" heart problems are cause for concern with the arryhthmias? Specifically, if I have a non-sustained Vtac episode for say 15-30 seconds are my chances of sudden death increased with this type of structural situation?

This type of structural heart disease typically causes atrial arrhythmias, not ventricular arrhythmias.  I would not worry about ventricular arrhythmias because of this.  The odds of sudden death from a ventricular arrhythmia in the absence of decreased left ventricular function are very low.  You can get a second opinion if you are concerned, just make sure you see someone that does not specialize in that procedure -- they would be more likely to recommend it.

I hope this helps and keep running.