Cause of TIA's? - Stroke Message Board

GiniaJ · 06-16-2001, 07:59 PM

I have had two obvious incidents of possible TIA - one a year ago with left side numbness from neck to foot, and one a month ago, with left arm numbness and confusion, temporary speech difficulties. I had a TEE (Transophageal Echocardiogram) on Monday of this week and while coming out of the sedation, the Cardiologist told me that I had a hole in the heart wall between chambers. I remember saying, "Oh, that is what caused the problem?" and he said yes. My husband filled me in futher on what the Cardiologist said, indicating that there is a left to right shunt of blood through this tiny hole into the other chamber, causing clots to form, that travel into either the lungs or off to the brain (thus the TIA's). This is all non-medical jargon and the understanding is not 100% complete, but think I got the gist. I have to have follow-up, and am waiting for bloodwork to come back to see what kind of treatment I will have (bloodthinners, I suspect). Has anyone else heard of this type of thing? If so, let me know what you found out. Thanks.

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GiniaJ

axe · 06-25-2001, 02:24 AM

What you describe sounds like a patent foramen ovale (failure of closure of a hole in the septum from birth). This increases the risk of paradoxical emboli (ie clots passing from the right side of the heart to the left side, and thus to the systemic system of the body - meaning the brain and not the lungs - like normal emboli known as pulmonary embolism)
The treatment of this often involves anticoagulation with either aspirin, or warfarin. Surgical closure is also sometimes an option - We have been doing closures of PFO's in the cathlab for a few years now which involves floating a catheter up the femoral artery in the groin, to the right atrium, and inserting a self-expanding disc that closes the patent foramen.

You need to note there are other causes of TIA which need to be assessed.

Cholestrol needs to be controlled
Blood pressure needs to be controlled
Diabetes managed if present
Stop smoking

And have your carotid arteries ultrasounded with dopplers to make sure there is no stenosis >70% (if so you will need a carotid endarterctomy as the risk of impending stroke greatly exceeds the risk of stroke with operation)

All the best