does PFO have a Murmur?

[dsp]

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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?

 

[hemoglobin]

You are right, PFO should not produce a murmur.

 

[q1108]

i have both but they tell me they're not related

 

[Adcadet]

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]

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]

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]

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]

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]

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]

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