“We detected some right-to-left shunting, consistent with PFO,” the cardiologist says, discussing the hole in Mom’s heart.
“Her mother and two of her brothers had that too,” my sister remarks. As a nurse, my sister understands exactly what the cardiologist is talking about.
PFO. Patent foramen ovale. A hole between the chambers of the heart that allows blood to travel through an unborn baby’s heart and body, while bypassing its developing lungs. At birth, when the baby’s lungs become functional, blood begins to flow through the lungs, and the foramen ovale soon closes. However, medical research suggests that in about 25 percent of the population, the foramen ovale remains open, and is associated with an increased risk of ischemic stroke. Doctors believe that the PFO can allow blood to bypass its normal route, acting as a window that can shunt blood headed to the lungs, which filter chemicals and blood, back into systemic circulation, and on to the brain or other parts of the body. According to the American Heart Association, if this counter-flow carries a clot, it can cause a stroke, and clots can even form in the PFO itself.
My mother is the youngest of four siblings, including two brothers who died of strokes at ages 62 and 70. For us, this is an important clue: family history of PFO and stroke. And there are other clues.
The stroke was caused by a blood clot lodged in her right carotid artery, obstructing blood flow to her brain. A deep vein thrombosis (DVT), also known as a blood clot, formed in Mom’s leg sometime after she broke her foot. One neurologist suggested that part of this clot traveled to her right carotid artery, causing the stroke. Another neurologist speculated that the stroke was caused by a clot that likely originated from the PFO.
And there is another clue. A blood test reveals a clotting disorder called lupus anti-coagulant. A propensity to clot. A broken foot combined with a DVT, PFO, and a clotting disorder. A perfect alignment of rare circumstances.
