25% of People Have a Hole in their Heart and Sometimes It's Serious

Lisa Swanson with family tree

Hiking and cooking were out of the question for Lisa Swanson during a spring break trip with her family in 2022. She didn’t have the energy to keep up with her grandchildren, but that was nothing new. She has struggled with shortness of breath and fatigue all her life, but it was getting worse. It wasn’t until she collapsed at the end of last year when she decided to see a doctor.

“I thought the lack of energy and being out of breath were normal – that’s just how my body was,” Swanson said. “Then one day at home, I had a fainting spell and hit my head on a door, so my husband said, ‘we’re going to get you checked out!’”

Swanson’s primary care provider referred her to Laila Payvandi, MD, cardiologist at St. Luke’s Heart Care Clinic.

“When a patient experiences a passing-out episode, the initial workup investigates potential cardiac and non-cardiac causes,” explained Dr. Payvandi. “I ordered an EKG, a heart ultrasound, a stress test, a brain MRI and had her wear a heart monitor for 14 days. We discovered Mrs. Swanson had a structural problem with her heart. On further investigation, I determined she had a patent foramen ovale (PFO), a hole in the wall between the top two chambers of the heart.”

25% of people have a hole in their heart. Sometimes it's serious. 

Hole in the Heart May Have Caused Mini-Strokes

Payvandi believed Swanson's PFO was serious. She consulted Richard Kettelkamp, DO, structural cardiologist and medical director at St. Luke’s Heart Care Clinic.

“We determined Mrs. Swanson’s PFO was abnormally large and likely contributed to a mini-stroke and caused her other symptoms,” Dr. Kettelkamp reported. “She didn’t have any narrowed arteries or blockages, no irregular heart rhythms or diseased arteries in her brain that would otherwise explain what she experienced."

“In normal circumstances, blood travels through the heart in one direction, from the right side to the left, through the lungs,” he continued. “In Mrs. Swanson’s case, there was bi-directional flow between the upper chambers of the heart. Blood from the lungs was recirculating through her heart instead of being pumped to the rest of the body. In addition, she had a right-to-left shunt, which means the blood was bypassing the lungs. Since the lungs act as a filter, if there is debris present, it can be pumped to the brain and cause a stroke.”

Same-day Procedure Repairs Hole in Heart

Dr. Kettelkamp is one of St. Luke’s cardiologists who specializes in structural heart issues. He recommended a PFO closure for Swanson to address the blood flow issue and prevent future clots. While the closure can be performed surgically, it is typically done through catheters from the groin. Dr. Kettelkamp was the first in Cedar Rapids to use the technique, introducing it in 2006.

Following her PFO closure, Swanson was able to resume the things she enjoyed right after the procedure, including her love of genealogy research. She could also add more active hobbies she was previously unable to sustain.

“After the procedure, I can’t tell you how much better I felt,” Swanson shared. “It was immediate – like someone gave me a shot in the arm. This year, I was able to hike during our family trip. I’m no longer out of breath, I have energy and I feel great!"

Her advice to others: “Get checked out. The cardiologists at St. Luke’s are lightyears beyond everyone else with their technology and resources. They are top-drawer.”

Drs. Payvandi and Kettelkamp concur about being proactive.

“If you have shortness of breath and find you can’t do the things you used to do, don’t pass it off as ‘getting older,’” Dr. Kettelkamp advised. “Go through the paces and investigate to make sure it’s not something else. Mention it to your primary care provider and be your own advocate.”

Learn more about how St. Luke’s stands out for heart and vascular care and is expanding specialized services for you. If you're experiencing troubling new symptoms, find a doctor near you.