Long-term migraine is actually a "careful" trick
The young girl has been troubled by migraines for a long time. After a series of examinations, it was discovered that the root of the disease was a small round hole in the heart.
How to "break a hole" in the heart?
Should I be treated for this situation?
Listen to what the doctor says.
Case replay: The root cause of the headache is in the heart
Xiao Wang is a girl in her 20s. She is usually in good health, but she has an old problem. She often has a headache on the right side, which is pulsating, accompanied by nausea, fatigue and other symptoms.
Xiao Wang thought it was because he was too tired and stressful at work, so he took a rest or took painkillers every time he had a headache.
Although the headache symptoms have been relieved, they still recur, which seriously affects Xiao Wang's work and life.
Xiao Wang has been to several hospitals and considered migraines, but none of them had a good treatment effect, so he came to the neurology clinic of our hospital.
After a series of neurology examinations, EEG, brain CT, cervical vascular ultrasound, and transthoracic echocardiography were all normal.
In the end, the doctor confirmed that the root of Xiao Wang's migraine was in the heart, because the heart had a "careful eye", and this disease was called "patent foramen ovale".
Xiao Wang further performed transesophageal echocardiography, which confirmed the existence of patent foramen ovale.
This small hole in the heart used to be very useful
What is patent foramen ovale?
The foramen ovale is a small hole between the left and right atrium.
When we are a fetus, blood will flow from the right atrium into the left atrium from the foramen ovale to maintain our normal blood circulation.
When the newborn was born, with the first cry, the pressure in the right atrium increased, and the foramen ovale was functionally closed, and the anatomical closure was achieved within 1 year.
If the foramen ovale is not closed after 3 years of age, it is called open foramen ovale.
Why does patent foramen ovale cause migraine?
It turns out that when patent foramen ovale occurs, the venous blood in our right atrium flows directly into the arterial blood in the left atrium through this hole.
Due to the slow flow of venous blood, micro-thrombuses are prone to appear in venous blood, and these micro-thrombi flow directly into the arteries from the foramen ovale.
If the microthrombus flows into the arteries of the brain, it can cause migraine or even cerebral infarction.
Patent foramen ovale is also a very important cause of stroke in young people.
Therefore, it is especially reminded that if young patients have repeated unexplained migraines or cerebral embolism, they must be wary of whether there is an extra "careful eye" in the heart.
Asymptomatic and no history of foramen ovale "may not" need treatment
What should I do if I have patent foramen ovale?
Don’t worry, the disease generally has a good prognosis.
Statistics show that 1/4 of adults suffer from patent foramen ovale.
The consensus of experts in the United States pointed out that for patients without any symptoms and a history of stroke, it is not recommended to intervene in patent foramen ovale; for patients with strokes, migraines, repeated dizziness and other diseases, professional doctors need to clarify the cause.
If it is considered that the symptoms are related to patent foramen ovale, the patient should avoid forceful coughing, defecation, forceful breathing exercises, weight bearing, sleep apnea and other actions that induce increased pressure in the chest cavity in daily life.
At the same time, neurology, cardiovascular medicine, imaging and other multi-specialty doctors are required to evaluate the patient's treatment methods based on the patient's age, bleeding risk, patent foramen ovale anatomy, stroke risk factors, imaging characteristics, and clinical clues.
The treatment of patent foramen ovale includes drug therapy and surgical treatment. The drug therapy is mainly anticoagulant or antiplatelet drugs, which can prevent stroke.
Surgical treatment includes interventional occlusion surgery and surgical treatment. Interventional occlusion surgery is a minimally invasive operation. The catheter is sent to the right atrium through the femoral vein at the base of the thigh, and then passes through the open foramen ovale to the left atrium, releasing A special occluder can further seal the foramen ovale to achieve the purpose of radical cure.
The surgical technique is mature, the patient suffers little pain, and the recovery is quick, and it has been widely used in clinical practice.
Text/Zong Min (West District of Chaoyang Hospital)