In the doctor’s office, they call it a “communication” in the heart or sometimes a “shunt.” When I asked if that was another way of saying a “hole,” the doctor laughed and said, “Sure, if you want to call it a hole, it’s a hole.”
What we’re talking about is called a “patent foramen ovale (PFO)”—pronounced foh-RAY-mun oh-VAY-lee—a hole in the heart that didn’t close the way it should have after birth. It’s a small opening between the upper heart chambers, or the atria. It’s normally present during gestation in the womb but closes up during infancy—except when it doesn’t. Then it’s called a patent—or open—foramen ovale. That’s what I’ve got, and it turns out to be the cause of most of my shortness of breath when I’m exerting myself. What’s happening is that some of the blood that should be getting pumped to my lungs for fresh air is getting shunted instead to the left side of my heart and sent back out to the rest of my body. And then my saturation O2 drops.
We learned this during some recent tests: one where they did an echocardiogram while injecting micro-bubbles into a vein, and another where they ran catheters into my arteries to measure various parameters, while having me pump away on an exercise bike until I was gasping. They gathered lots of good data, I was assured. They thought I might have pulmonary hypertension, but I don’t.
What does this mean about the pulmonary fibrosis? Well, I still have it; that hasn’t changed, alas. But it’s milder than my breathing needs would indicate. The accusing finger points at my heart for that.
The good news is, this is something they can probably fix. First, though, I have to get scheduled for another test, to get clearer images of the shunt. If that goes as expected, then I’ll be, er, shunted to cardiology for the next phase.
Stay tuned. It should be exciting.
This is a railway shunt. Not really what we’re talking about.