Correlation between PFO symptoms and super active lifestyle?

I have an observation.  I hope some of you will chime in to let me know what you think.

I have been reading all the posts related to PFOs on this site mostly, but also on a couple of other places.  In addition, since my sedentary lifestyle due to my condition and now during my relaxing days of recovery, I have been doing a lot and LOTS of research to try and understand my condition - for me the more I know the better I feel.  I think it is safe to say that at this juncture of PFO research and knowledge, doctors DO NOT KNOW why we suddenly get symptoms (some of us more suddenly than others) after having lived with this hole in our hearts all of our lives.

I have also noticed that a lot of us who post are very fit and very active people (divers, runners, bikers, soccer players, etc.).  Or at least we were until we started developing our nasty symptoms!!!  I don't know if this is a trend of just people who post or a trend for people who have PFO symptoms in general.  I have started to wonder if there is some type of correlation between being super active physically and developing the symptoms?  Maybe we can throw age into the equation as well.  Perhaps when we were younger and very active, our bodies would compensate somehow, but as we get older, it is harder for our bodies to compensate for the hole in our hearts???  I have read and heard from my doctors that many people start developing symptoms in their late 30's or early 40's.  Some of you may have started having symptoms around this time, but were not diagnosed until much later because you thought your symptoms were just part of the aging process.  I know that if my symptoms had not developed so suddenly and my health had not started deteriorating so rapidly, I would have probably just chalked everything up to the aging process and left it at that.  I just wonder if there is something to this idea I am having.

I don't know how active some other members have been, but I know that some of you have 4 or 5 children, like Mamanuss for example.  I have read that the whole process of pushing, lifting, etc.  causes more of the "saline bubbles" to move from one side of the heart to the other (I know we've all heard of the famous Valsava Maneuver).  Hence lifting weights, children, and generally being more active would make more blood go from one side of the heart to the other and can thus exacerbate the condition and/or the symptoms.  Hmmmm.....

My partner and I were discussing this the other day and he compared our hearts to engines.  He said that it's as if you have an engine and after a while if you push it too hard it will start to fail.  I said that it wasn't so much the pushing too hard, but more that the engine is defective to begin with.  So we have an engine that is defective, and then some drivers push the car engine to its limits because that's what we like to do (we like to race!) or what we have to do (we have 5 kids!), over a period of 30 or 40 years.  Isn't this engine more likely to falter sooner than an engine that is pushed too hard but is not defective, or one that is defective but is not taken for long hard drives and sits in the driveway most of the time?

I hope you will help me think this through.  Who knows, we may be on to something and we may be helping others who will come after us.  With more answers, hopefully their journeys will be a little easier than some of ours have been!

I am sending lots of positive and bright thoughts in everybody's way.

Greenhope

Hi Arthurg72,

I have wondered about that myself and the only thing I can think of is that other parts of our body and even our heart compensate when we are younger.  But, once everything starts to age, the defect becomes noticeable because other body organs are not able to compensate like they used to.  I also have this ugly image in my head of our hearts stretching downward as we get older, as everything else in our bodies does, and thus perhaps the hole also stretches and becomes more pronounced/bigger as a result?  These are just ideas and unflattering images!  Hopefully some super doctors are already researching some of these things and life will be easier for future generations of PFO/ASD sufferers.

Thank you for sharing your thoughts,

Greenhope

i have been reading the healingwell pfo posts for three days...sucking what info. i can get. at one time feeling, "wow, i am not the only one" and at other times feeling, "holy heck! i am not sure if i can go through all of that." (small stroke 9/2/08) much easier to ignore the fact that i have a pfo and just continue to run races and triathlons. i do agree with the fact that there must be a link with an active lifestyle. but if we can see it why not the doctors? why aren't they making the connection?
anyway, 2 weeks ago i ran my first marathon and went to see my cardiologist the week before i ran it...had not seen him in a year. basically, he thought i was crazy to run the race with the stroke/pfo issues and told me he was now going to recommend the procedure if i was going to continue my lifestyle.
so basically, you all are scaring me to death about having the procedure. i am fine (but for being tired alot...could just be effort and age). i want to get off that table and be able to resume racing within a month. i don't want heart palpitations, "chicken bones" in my throat, numbness, headaches, dizziness, etc...
why did you do it? being athletes...why did you decide to risk that? it is such a joke to have to choose between a possible stroke that could kill you or never even happen again (american heart assoc/amer. stroke assoc. call it the 2 stroke rule) and a procedure that is not a sure thing, could cause other issues and basically places a foreign object in a vital organ. it is russian roulette either way.
anyway...my two cents, i guess...
hope i wasn't too confusing. greenhope, kudos to you for keeping up with your postings...you have been a great help.

*i have read that dehydration can be an issue with clotting...i watch that b/c i dehydrate easily. considering they never found any other answer for the stroke i am going with that. pfo's do not cause strokes..considering 25% of the population walks around with them but 25% do not have strokes. so, that speaks to the athletic factor.

greenhope...

i did miss your beginning...3 days and many different stories.
how active where you before your heart started to fail (you were saved so you could help all these other people through a confusing, scary time)? what were your early symptoms? was it a slow process before you realized things were really bad? now, do you feel like you can get back to participating fully in sports again?
i am going to go back and read your story...

np

Hi, 01IRISH, and welcome to this forum.  I can only tell you what I am planning to do and what I know; perhaps this may help in making your decision.  I think they only do the echo because the main concern for them (doctors) is to make sure the PFO is closed.  The echo provides a lot of information, but the TEE provides much more.  My failing heart valves (mild & moderate) and borderline pulmonary hypertension were only detected when they finally did a TEE (after much persistence from me!).  So, at 3 months after my PFO closure, this coming Monday, I am going to let them do the echo because the main thing we ALL want to know right now is whether the hole is closed or is at least making good progress.  At 3 months this is all I can expect.

However, at 6 months, I will "nicely ask" first, but DEMAND if necessary, that a TEE be performed.  I will try to reason with my cardio, who is a wonderful and understanding person, and tell him that I need to see that my heart is functioning better, i.e., valves are working better, the right side of my heart is no longer overworked, no more borderline pulmonary hypertension, etc.  All those wonderful things that only a TEE can tell you and that will hopefully have improved after 6 months.  I hope that as an intelligently thinking cardio doctor, he is already planning to do this so I won't have to persuade him.  But, if I need to persuade him, I will and if I need to demand the test, I will do that as well.  It is my right as a patient to get the treatment I think I need and I will take a copy of my first TEE in case he needs a reminder of what my failing heart looked like!

I hope you are able to demand the same (because of your name I am not sure whether you live in the US or Ireland).  If you live in Ireland the process may be different.

Good luck!

Greenhope

I am fit and I have been extremely active throughout my life. Playing all kinds of sports, contact sports, karate, gym (cardio and heavy weight lifting) 3-5 days/wk for years, running and so on. I'm 41 and just had a stroke two weeks ago, doctors say its from a "PFO" and some bloodclot that made it to the brain through the "PFO". I'm now waiting for a "PFO" closure to be performed, some insight on this would be great. Thanks 

Yes, Thats the Echo test that was done in Boston at Brigham and Womens Hosp.

Hi Tom D and welcome to the forum.  I would also encourage you to read the PFO closure threads where you will get much valuable information on PFO closure procedures.  I know they helped me a lot when I was going through that process.

Greenhope

I'm really not a good candidate to answer you Tom. I was one of the unlucky ones to experience problems with the procedure and afterwards. It will be a year for me in April and as of my last echo I was still not closed. If I'm still not closed at 1 year then I may very well have to make that decision. Looking back on what I have been through if I had to do it all over I might very well choose the open heart surgery. There are many people though that have gone through this with no problems what so ever so you can't base your decision on me. I think the odds are more in favor of no problems at all.

I saw my Doc on Wednesday he told me he's not 100% sure that we are dealing with a PFO or ASD so he made an appointment for me to have a TEE. "Any insight on this would be nice" Thanks

Tom H - I was out for the TEE as well, and I think I would request it! You should read Teddy B's book ( Patriot's football player), " never give up" if you have not already. I found it helpful and my doctors are from Boston as well at mass General. I had my pfo closure 6/2008 and things went fairly smoothly. Boston is one of the best places in the world to seek top medical care.

best of luck - RF1

I thought after closure everything would be great, my life back and all that...... my blood pressure for the last few weeks is around 98/160 (that was yesterday) I had a CAT scan yesterday to see if I am having TIAs but that wasn't clear so now I am waiting a MRI and 9/3/09 I will be wearing the heart monitor for 24 hours then a scan and after that it will be an echo!!!!! I was starting to ride my horse and build my fitness back up. Like many on this forum I have always exercised (extremely in my case having horses!) but 2 years ago that all changed. So maybe Greenhope you have hit on something?

This is getting crazy, after the doctors got together and looked at my TEE they changed there minds again. They now told me that I indeed have a "PFO" not a "ASD", they said," Its larger than they normally see so they thought it was an "ASD". Problem is my doctor tells me it should definitely be closed but the US government won't let them perform the "PFO" closer with a device unless you have two "TIA's" or more. Has anyone else run into this brick wall? I'm starting to lose my mind over this whole thing.