#湖南省中西医结合医院 ##长沙头条#
If you are suffering from unexplained headaches and migraines, troubled by recurrent strokes, worried about unexplained syncope, and cannot find the cause after multiple CT and MRI examinations of the brain, it may be that there is a "hole" in the heart - patent foramen ovale (PFO).
1. What is patent foramen ovale (PFO)?
Our heart is equivalent to four chambers, there is a left atrium, left ventricle, right atrium, right ventricle, there is a wall between the left atrium and the right atrium, separating the two, this wall is the atrial septum, and there is a name in the middle of the atrial septum called the foramen ovale.
The foramen ovale is open during the fetal period and normally closes within one year of birth, but if it does not close over the age of 3 years, it is called patent foramen ovale. About 25% of people do not close the foramen ovale.
2. How to detect patent foramen ovale?
Routine transthoracic ultrasonography combined with right heart sonography is more sensitive to detect potential patent foramen ovale.
Xie Qun, director of the ultrasound department of Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine), will take you to understand right heart sonography:
3. What is right heart sonography?
Right heart sonography is to mix a small amount of normal saline with your own blood, fully shake to form microbubbles, and then trace the walking path of these small bubbles to explore whether there are "holes" in the heart.
Normally, these small bubbles cannot pass through the capillary network of the lungs and only travel in the right heart system, but if there is a "hole" in the wall of the left and right heart rooms, the small bubbles can enter the left heart system through this "hole", and microbubbles will appear in the left heart system at the same time, indicating a positive sonography of the right heart and a patent foramen ovale.
Based on the time when the microbubbles appear in the left heart system, we can preliminarily determine whether it is an abnormal channel in the heart (patent foramen ovale, atrial septal defect, etc.) or an extracardiac problem (pulmonary arteriovenous fistula, etc.).
(▲Figure 1 is normal, Figure 2I, Figure 3II, Figure 4III)
4. Is right heart sonography harmful to the human body?
Right heart sonography is safe and reproducible. In general, there are no obvious adverse reactions, and a very small number of respiratory symptoms such as cough and dyspnea and neurological symptoms such as dizziness and numbness of limbs can last for a few minutes, and return to normal after one hour without sequelae.
5. What are the conditions that require right heart sonography?
Sonography of the right heart may be performed clinically to help confirm the diagnosis in the following situations:
1. Unexplained headache and migraine, especially for patients with aura.
2. Patients with unexplained ischemic stroke, transient ischemic attack, asymptomatic cerebral infarction, and unexplained syncope.
3. Detection after patent foramen ovale closure.
4. Differential diagnosis of perpetuated left superior vena cava and isolated coronary venous sinus dilation.
5. Patients with suspected pulmonary arteriovenous fistula, venous malformation drainage, or diagnosis of some congenital cardiovascular malformations.
6. It is necessary to know the size of the right heart chamber, the edge of the endocardium, the thickness of the ventricular wall, the presence or absence of a mass, valvular regurgitation, etc.
7. To improve tricuspid valve and pulmonary artery blood flow spectrum Doppler signaling.
8. To find the cause of hypoxemia.
Of course, the specific need for this test depends on the patient's specific situation and the evaluation of the specialist.
Hunan Medical Chat Special Author: Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine) B-ultrasound room Li Na Liu Yuwan
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(Ed. ZS.) Image source network, invaded and deleted)