Heart holds key to some migraines


Kristi Rohr started getting migraines when she was just a kid- in sixth grade. Eventually, the headaches took on a life of their own, and took over every aspect of hers.

(kristi rohr/migraine sufferer)

"I would start losing my vision. Ten minutes later, if someone were standing in front of me, I wouldn't be able to identify who that person was. I would then have numbness in my left hand. It would go into my face. My nose would become numb. My mouth, my tongue, my eyes would twitch. And I would have difficulty speaking."

Kristi suffered from complex migraine with aura. The symptoms mimic stroke and can be terrifying for patients, says , McLaren Dr. Ahmad Munir, "The only thing that differintiates these symtpoms from having a stroke is that these symptoms last for much longer during a stroke."

At first, Kristi suffered one or two of these migraines monthly, but they eventually took over her life.


"I became pregnant with twins," Kristi tells me, "And my first trimester, I had three really horrific migraines in one week and I was extremely sick."

Eventually, Kristi's doctor recommended further testing- for a congenital defect called Patent foramen Ovale or PFO.

The Foramen Ovale is a hole we all have in the womb, that allows our mothers to send oxygen to our lungs. After we're born and breathing on our own, it usually closes.

In 25 percent of people, however, Dr. Muni says, it stays open, allowing blood to flood from the right to the left chamber of the heart, "In most patients, it doesn't cause any symtpoms, but if you have other diseases, like if you are forming blood clots in your legs or if you have migraine, then this abnormal shunting of blood can cause you to have a lot of symptoms; and some patients can have a stroke."

Not everyone who has this defect suffers migraines, and not every migraine suferrer has the defect. But, Dr. Munir says it's possible the PFO allows migraine causing chemicals get to the brain, "The chemicals that are released that are supposed to be neutralized by the lungs are not, and they reach the brain and exacerbate neurological symptoms associated with migraines."

Still, Dr. Munir says only a limited number of migraine patients are screened for PFO, "This is not something we routinely screen for, because it is only in certain circumstances that it causes a problem and would need to be repaired."

Kristi's migraines were altering her life, so she had the PFO repair, "It's all-consuming because you are so afraid of getting them. And now I don't get that, so from a mental standpoint, I've been able to close that door. And I haven't had any neurologic symptoms since I've had the PFO closure."

The surgery to repair the PFO defect used to be extrememly invasive, with a large chest incision. Dr. Minurrepaired Kristi's hole with a patch, inserted via ultrasound-guided catheter technology, and very small incisions.

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