Possible PFO indicator????

[mikerault]

Just this afternoon I hada huge sneezing fit, afterward my left arm tingled and my left hand had pain as well. Could this indicate a PFO? Should I be worried? Up until an ACL injury about a month ago I was running a mile, doing weights and then doing 18 pool lengths (olympic pool) about 3 times a week with no issues.

Mike

 

[Dr Deco]

Hello mikerault :

If you had a sneezing fit [or coughing fit] right after a dive, I might be suspicious. That might be an interesting way of testing for a PFO - if it worked.


Dr Deco :doctor:

 

[mikerault]

Nope, just sitting here in my office.

 

[Dr Deco]

Hello mikerault :

There is the possibility that you had a paradoxical embolism, that is, a clot in the venous system that moves into the arterial system. A sneeze is one type of "Valsalva maneuver."

Emboli typically come from the heart or the carotid artery [in your neck] and move to the brain. They are termed paradoxical because it was considered a paradox that they could pass through the filter of the lung circulation. They actually pass through a PFO and bypass the lung.

Many individuals with migraines have a PFO. [My wife tells me about 50% of people with migraines.] Do you suffer from migraines?

Dr Deco :doctor:

 

[mikerault]

I used to, but haven't in a while (they went away after I stopped sleeping with my neck against the couch arm where a seam pressed on just the right area). As a youth I had cluster headaches but they went away at age 17.

 

[HBO MD]

I guess it depends on what you define as a "huge" sneezing fit. Some people actually hyperventilate transiently. This causes a transient drop in blood calcium which may manifest as tingling.
It seems quite unlikely that this is a manifestation of a PFO.

 

[Dr. Doug Ebersole]

I agree with HBO_MD. I think this would be an extremely uncommon presentation for a PFO. And this comes from someone who closes these things for a living (I just closed one earlier today)

 

[mikerault]

Ok, thanks, it was just kind of strange.

 

[nereas]

Along the same lines, with such professional talent assembled here, I wonder if turning blue in the face upon extreme exertion might be the sign of a PFO?

I saw this once in a dive student during a rescue class while they were hauling "victims" through the surf. He turned really, really blue, although he did not faint however.

 

[HBO MD]

Hi Guys,
One other thing in terms of the arm pain etc, again depending on how vigorous the sneeze fit was, is a neck problem. I suggest this due to the radiation of the pain, hand etc. If it was to persist, I would have someone look at it in terms of that possibility.

Now in terms of color change : turning a deep blue in the face while in the surf is almost certainly due to a combination of cold ( I assume it was cold and he was suited up elsewhere), +/- venous congestion if he was exerting himself...straining in other words. I wouldn't worry about it. Just make sure he gets a lipstick color to match

Safe diving guys.