Every night since my headache specialist recommended I get tested for a patent foramen ovale (PFO), I have lain in bed at night visualizing my heart with a hole in it. As if imagining and hoping for this defect would make it so. I so desperately want to have this hole in my heart because many migraineurs have experienced a reduction in the frequency and severity of their migraines after having their PFOs closed. This exemplifies one of the strange ways chronic intractable migraine has changed my thinking: I want to need heart surgery because there is a chance that it might finally offer an effective treatment for the migraines.
Wondering what in the world a PFO is and how it relates to migraine? Here’s what I wrote about it in 2008:
The hole, called a patent foramen ovale (or, more commonly, PFO), is an opening between the upper chambers of one’s heart. Some migraineurs who had PFOs closed for another reason reported that their migraine attacks stopped or were much less frequent after the surgery.
The hole is present in fetuses to allow blood to pass from one side to the other. In most people, the gap closes at or after birth. For an estimated 25% of the US population, it doesn’t close completely and the PFO forms. This remaining tunnel functions as a valve. Normally the valve is shut, but sometimes remains open, sending blood that’s supposed to go to the lungs off to the brain and other parts of the body.
Are Migraines Linked to a Heart Defect? is a helpful Q & A in the New York Times from 2010. I can’t find any recent stories on it. What I understand from talking with my headache specialist is that PFO closure has been helpful for migraine with or without aura (most early reports focus only on migraine with aura) and — though I have a hard time believing I heard this correctly — 80% of migraineurs who have PFOs closed report some degree of migraine relief following the surgery.
My fingers are crossed until I get the test results tomorrow.
8 thoughts on “Hoping for a Hole in My Heart”
I had a PFO closure one year ago next month and have reduced my headaches from 10-12 per month to 1-2 per month. I have also been removed from all of my preventative medications that I took for nearly 20 years. This surgery has been a god send for me and was very simple. I had surgery on Friday and was back to work on Monday. While you do need to check with your doctors and make the right decision for you, this has truly been a miracle for me.
That’s fantastic, Melissa! Great news that the surgery has been so helpful for you.
Hi Kerrie, My name is Drew and I also suffer from Headaches(NDPH) on an exstream daily basis. I have found out a few years ago that I do have a PFO and that it could be closed with a newer kind of surgey that does not involve cracking open my chest to get at the problem. Though I would like to have it closed due for the same reasons that you talked about,there is only one problem. The research on this subject has led me and my doctors to one simple reasoning of thought. The proceedure is just not worth it. There is no garantee that closing the pfo will stop the headaches in the short term or long term over your life time. There is also the very possible chance that you could suffer even more complacations from the surgey, by no means is this surgey a fix it. Remenmber it still intails your heart and messing with the bodies system. After many talks with the right doctors the proceedure is not a very good option for many of us that suffer from headache. There is more that could go wrong than there is a chance that the surgey can fix the problem.
Thanks for sharing your story, Drew. I absolutely agree that someone needs to weigh the pros and cons before making such a major decision. Turns out I do not have a PFO, so it is a moot point for me. All the research I know of has been done on migraine, so I’d be especially wary of trying it for a different type of headache, like NDPH. I wish you the best of like in finding an effective treatment.
May I ask what kind of examination you took to identify a possible PFO?
I had trouble finding a good way to link to the information, but if you Google “PFO bubble test” (no quotes), you’ll find some descriptions of it. It was super easy and painless.
I wanted something curable to show up on my MRI when this first started. Glad you have something to try.
Nope, no hole in my heart. I’m not as discouraged as I thought I’d be and my appointment with the headache specialist was good. Increasing preventive magnesium infusions to every 10 days and will meet with him again next month(ish) to discuss meds.
I can relate to “wanting” something to be wrong. When I got my first CAT scan at the age of 19, I remember thinking that having a brain tumour wouldn’t be the worst thing in the world if it meant that it was cause for my migraines.