You may recall that in September, former Real Housewives of Atlanta member, Kim Zociak-Bierman had to leave as a contestant on Dancing with the Stars, after she suffered from a transient ischemic attack (TIA) after a plane flight back to Atlanta. During the “mini-stroke” Bierman was unable to speak, and the left side of her went numb. She was discharged home on blood thinners after her symptoms resolved.
An evaluation to figure out way Kim may have had the TIA revealed that she has a small “hole in her heart,” known as a patent foramen ovale, or PFO. She will undergo surgery to repair the condition. Here, Kim discusses the diagnosis with Good Morning America co-host Michael Strahan:
When a baby is in the womb, it gets all the oxygen it needs from its mother through the umbilical cord. Since the lungs are not used, the neonate’s circulatory system shunts blood away from the lungs until birth when the baby takes its first breath. One way it does this is through a small opening between the upper chambers of the heart- the right and left atria called the foramen ovale. This opening functionally closes within the first couple of days of life, and then is permanently sealed over the first one to two years of age. However, in approximately one in four people, the opening does not permanently seal closed.
Unless there are other associated defects, there are usually no complications associated with a PFO. There have been some studies suggesting that older patients with PFOs have a higher rate of a certain type of stroke (called paradoxical thromboembolic stroke). The reason for this is that older people frequently develop blood clots in the veins in their legs. These clots can sometimes travel from their original site to the right side of their heart.
If a PFO is present, the clot can then pass from the right side to the left side and may travel to the brain and become lodged there, preventing blood flow to that part of the brain (stroke). It is interesting to note that Kim’s TIA occurred after a long plane ride from the West Coast, which can predispose a person to develop blood clots in the legs.
Although we do not know what kind of procedure will be done on Kim, the defect can now be repaired using a “catheter-based procedure.” During the procedure, which routinely takes 1-2 hours, a long flexible catheter tube is threaded through a large blood vessel in the groin up into the heart. A PFO closure device (see an example in the picture, right) is moved through the catheter to the heart and specifically to the location of the heart wall defect. Once in the correct location, the PFO closure device is allowed to expand its shape to straddle each side of the hole. The device will remain in the heart permanently to stop the abnormal flow of blood between the two atria chambers of the heart. The catheter is then removed and the procedure is complete.