TEE anyone?

[dainbramage]

Having a TEE on April 5th. Guess the swollen legs, migraines and high heart rate is a problem. So they are looking for a PFO. A friend of mine's wife had a PFO and she had swollen legs and migraines. He told me she had her PFO fixed and she hasn't had a migraine since. I am not hoping for this but in the back of my mind its a little hope. Has anyone had this done? Has anyone had a PFO?

[CAT1962]

Acronyms!  Didn't get a  word of that..LOL..Sorry, Dain...

[season]

WHaaaaaaaaat?

[angielyn]

Pretty sure PFO is a hole in the heart that can cause migraines.

[ThatGuyJason]

A PFO, or patent foreman ovale, is an opening in the wall between the right and right atria of the heart.  It's purpose is to bypass the lungs when you are in the womb.  You are getting your oxygen from mommy and not breathing in any.  Once you are born, it typically closes up on its own.  It is not uncommon for it to remain partially open though.  There have been links between an open, or patent, foreman ovale and migraines, but I have never really heard the details on how or why.  The procedure to fix it is kind of cool.  I have been able to observe a few.  They enter through the thigh and snake a probe up into your heart.  At the end of the probe is a wire mesh device (the name escapes me at the moment).  There are a few different types, sizes and shapes.  Basically it is like an umbrella, they push it through the foreman ovale, until it is able to expand in the left atria of the heart.  Then they pull it back against the atrial septum, sealing off the opening.  Depending on the type, they will also mushroom out the right atiral side, but not all have that part.  Your blood pressure is general enough to keep it in place.  They unscrew the end and withdraw the probe.  With the mesh in place, you body is able to make a scab like formation and eventually heal over and close the hole.  Again, I know there has been studies about a llink between that and migraines, but I don't know the science behind it.

[hikerknees]

Hi, I didn't know these either so looked them up:
TEE is Transesophageal Echocardiogram and PFO is Patent foramen ovale.  I have one of the latter and it was picked up on a regular ECHO, however I hadn't heard the link to migraines before.  I go to my Rheumy on Friday to review some of my tests and etc, so I'll add it to my growing list of questions.  Is this common with Sjs too?

[ThatGuyJason]

As far as the TEE goes, it is a trans esophogeal something-or-another.  It is basically an ultrasound done by going down your esophagus (food pipe) to get a better look at your heart and the valves.  I have only seen them used when closing a PFO, though I am sure it is used at other times as well.  When I saw them do it, they would inject little puffs of dye from the probe entered from the thigh into the heart.  The dye would show up on the TEE screen and the could follow the path of the blood into the right ventrical or the left atria via the PFO.

[ThatGuyJason]

A PFO is common in around 25% of the population.  It is generally left alone and no real concern.  They usually don't mess with it unless you have a history of strokes.  The whirlwind caused by blood entering can cause some pockets of blood to sit still for a bit and not exit the heart.  This can cause it to start to clot and then lodge elsewhere and cause a stroke.  As far as migraines, I am not sure of the logic behind the link.  But I was only a paramedic, and that was way above my level of care.

[hikerknees]

Thanks Jason for the description, my migraines are not at all severe enough to ask for that procedure.  I do see there is a lot about a possible connection between PFO and migraine on the web, and that they haven't established a clear link.  Dainbramage, I'm glad your friend's wife got good results, I hope you find some relief too.  Let us know what they find out at your TEE--having a TEE sounds very British lol.

[anita]

A TEE is used for other things as well.  I had one after seeing an ASD (atrial septal defect---hole in the heart wall) on a regular echo.  They used the TEE to see if it was actually leaking blood in the wrong direction (which it was).  They were also able to see an atrial septal aneurysm which meant the wall was shaped like the letter "S" instead of being straight.  I had to have open heart to fix both.

The TEE procedure itself isn't bad.  They give you a little Versed and you don't remember a thing.

Good luck with it and let us know what they find.

[susan]

I had a TEE to rule out subacute bacterial endocarditis.
Anita is right, in terms of comfort, it is an easy test. I was given fentanyl & versed----felt nothing, remembered nothing!
Good luck, I hope the results are helpful.

[dainbramage]

I am so sorry about not writing out the words, since I work in the hospital and I deal with PFOs and TEEs, I forgot some people don't have hospital lingo down. I know how each procedure is done cause I have to sit with my (babies) patients who are having these procedures and it isn't so bad. I just wondered how many people have had this. I was amazed my co workers wife's PFO caused migraines and when I looked it up, this is one of the symptoms along with high heart rate and swollen legs. He also suggested to go with our ped cardiac doctors since this is what they do constantly. I will because I don't think the adult cardio deals with too many PFOs. I don't have a murmur. (I listen with my stethoscope to my heart) I was very active in sports when I was young and I did not have trouble then, like you hear about kids dying after playing sports.
Only if I can come off one med I would be happy...
Thank you guys

[angielyn]

Well, what is the difference between a TEE and an RFA? I had an RFA for WPW years ago. Just curious really 

[Linda196]

RFA is radio-frequency ablation, WRW is Wolff-Parkinson-White, a disease of altered electrical stimulation of the ventricles of the heart. In RFA the abnormal pathway is ablated (essentially destroyed) by radio waves, allowing  a normal pathway for the electrical stimulation to conduct from the atrium to the ventricle.

A TEE is diagnostic, while a RFA is therapeutic.

[dainbramage]

TEE came back normal there was not a patent foramen ovale (hole in heart), but I have one valve not closing all the way, but no regurge from the valve. So waiting for the next test. What other tests has anyone had?