dsp

Member
7+ Year Member
15+ Year Member
Jun 3, 2002
89
0
Status (Visible)
So on ER for the last 4 months, Forrest Whitaker has been playing a guy who had a PFO and a stroke 2/2 this. Luka gets castigated because he "missed" the murmur.

My question is this- i thought PFO doesnt even have a murmur. Am I wrong on this?
 
About the Ads

Adcadet

Long way from Gate 27
10+ Year Member
15+ Year Member
Jul 22, 2002
2,155
13
44 deg 1 min 11 sec N, 92 deg 28 min 55 sec W
Status (Visible)
  1. Resident [Any Field]
You think they could have somebody read their script and verify some basic medical information! Whenever they said "PFO" (which does not produce a murmur) I just imagined they said "VSD" (which can have a murmur).
 

tivark

Junior Member
10+ Year Member
7+ Year Member
May 20, 2006
44
5
Status (Visible)
  1. Medical Student
does PFO mean patent foramen ovale?
cos if it does this creates increased flow from the left atria into the right atria >> increased flow into right ventricle >> flow murmur as increased blood goes past the uplmonary valve ie systolic ejection loudest in left 2nd ICS.

so yes there is a murmur
 

Gastrapathy

I’m just here so I don’t get fined
10+ Year Member
Feb 27, 2007
5,520
5,025
Status (Visible)
  1. Attending Physician
does PFO mean patent foramen ovale?
cos if it does this creates increased flow from the left atria into the right atria >> increased flow into right ventricle >> flow murmur as increased blood goes past the uplmonary valve ie systolic ejection loudest in left 2nd ICS.

so yes there is a murmur

15+% of the population has a PFO and most are silent.
 

joti

Junior Member
10+ Year Member
7+ Year Member
Mar 7, 2006
84
0
Status (Visible)
  1. Resident [Any Field]
So on ER for the last 4 months, Forrest Whitaker has been playing a guy who had a PFO and a stroke 2/2 this. Luka gets castigated because he "missed" the murmur.

My question is this- i thought PFO doesnt even have a murmur. Am I wrong on this?

Yes PFO can have murmur theoritically. But realistically no. The pressure difference between the RA and LA is minimal. So there wont be significant shunting. But this is not the situation in a VSD. RV and LV pressure differnce is remarkable. But the PFO is very large the there can be larger flow and can have murmur (Theoritical). Otherwise paradoxical emboli can occur only in Eisenmenger like phenomenon in the atria which is not the case in PFO.
 

tibor75

Member
10+ Year Member
5+ Year Member
May 11, 2006
459
3
Status (Visible)
  1. Attending Physician
does PFO mean patent foramen ovale?
cos if it does this creates increased flow from the left atria into the right atria >> increased flow into right ventricle >> flow murmur as increased blood goes past the uplmonary valve ie systolic ejection loudest in left 2nd ICS.

so yes there is a murmur


Nope. A PFO almost never causes enough blood flow to lead to increased RV flow.

ASD - yes

PFO - no
 

Soul

New Member
10+ Year Member
May 20, 2007
7
0
Status (Visible)
  1. Medical Student
paradoxical emboli can occur only in Eisenmenger like phenomenon in the atria which is not the case in PFO.
Is Eisenmenger phenomena must present for the development of paradoxical emboli--stroke in PFO? Can PFO alone lead to Eisenmenger syndrome?
 

P Diddy

california lover
15+ Year Member
Feb 17, 2002
550
25
Podunkville, CA
Status (Visible)
  1. Attending Physician
Is Eisenmenger phenomena must present for the development of paradoxical emboli--stroke in PFO? Can PFO alone lead to Eisenmenger syndrome?

1. No. PFO itself is a risk factor for stroke. there are transient elevations in R atrial pressures that cause R atrial > L atrial pressure and flow through the PFO (ie coughing, Valsalva). Paradoxical emboli can pass through the PFO in these situations. Eisenmenger's syndrome is not necessary.

2. I have never heard of PFO leading to R heart failure since the PFO is usually shut under normal physiologic conditions. Only with persistent, high flows across the interatrial septum (ie ASD, I believe someone above mentioned this) will Rv hypertrophy and failure develop.

p diddy
 
About the Ads
This thread is more than 14 years old.

Your message may be considered spam for the following reasons:

  1. Your new thread title is very short, and likely is unhelpful.
  2. Your reply is very short and likely does not add anything to the thread.
  3. Your reply is very long and likely does not add anything to the thread.
  4. It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
  5. Your message is mostly quotes or spoilers.
  6. Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
  7. This thread is locked.