Healthbeat Report: Hearts and Headaches

April 16, 2009 It's a controversial theory, but some patients and researchers say there's too much evidence to ignore.

The cause of migraines remains a mystery. But what if some of these headaches start in the heart and not the head?

Believers say this hypothesis needs to be investigated because there have been so many reports about migraines disappearing once a heart defect is fixed.

Linda Gray is in control and loving life.

"My life has a better quality. I enjoy it," said Gray.

At the age of 48 she had two strokes.

That's when doctors discovered the likely cause: a fairly common heart defect known as a patent foramen ovale or PFO.

It's a gap in the wall between the upper chambers of the heart and it was closed in a minimally invasive procedure like this one.

Linda says soon after, she felt great and then she noticed a strange coincidence.

"My husband had mentioned it to me, 'you are not getting headaches,' and I thought about it and said you are right," said Gray.

Linda had been plagued with debilitating migraines since she was a teenager. Medication was not working.

Now at the age of 61, the severe headaches are all but gone. Linda thinks having her heart defect closed helped.

Cardiologists such as Louis McKeever say this story is not unique.

"What has been found anecdotally (butt) if you close a PFO on patients with certain kinds of migraines um we have noticed half of those patients have a pretty dramatic improvement sometimes a total elimination of their migraines," said Dr. Louis McKeever, Interventional Cardiologist, Midwest Heart Specialists.

Why would closing a heart hole have an impact on headaches? When you have a PFO some of your blood goes the wrong way, sometimes directly to the brain instead of through the lungs. That's what may put people at risk for stroke.

And some researchers suspect the unpurified blood can also trigger migraines.

But what remains unclear is whether closing up this gap truly brings relief.

"There's no question that there is improvement but how much improvement is placebo effect or is it the effect of closing the hole this remains to be seen," said Dr. Ziyad Hijazi, Interventional Cardiologist, Rush University Medical Center.

A large clinical trial called MIST II was supposed to test this theory but was canceled because the trial was too strict to get enough patients.

So debate continues with some studies saying no to a connection and others leaving open the possibility.

"I think the story is still unfolding. I think all of us in this field have seen pretty dramatic improvements in patients that you would never expect them to improve and they do," said Dr. Louis McKeeve.

Eileen Mahler, a heart patient at rush recently found out she has a pfo. She also suffers from severe migraines.<.p>

Eileen wants the surgery to close her pfo. She's aware there's only anecdotal evidence it could help her headaches. But she also worries the gap could cause other problems.

'"I'm very hopeful they will go away also decrease the risk of yeah I would be ecstatic if they did," said Mahler.

Doctors warn that running out and getting an echocardiogram to look for a PFO is not the best idea.

It's thought one out of five people have this defect but have no signs of trouble.

We're told a newer company now wants a shot at testing the pfo migraine theory and talks of a new trial are underway.

Dr. Louis McKeever
Midwest Heart Specialists
429 N. York Rd.
Elmhurst, IL 60126
Phone: (630) 782-4050
Fax: (630) 782-5021

Midwest Heart Specialists
801 South Washington Street, Edward Heart Hospital 4th Floor
Naperville IL 60566

Dr. Ziyad Hijazi
Rush University Medical Ctr.
1653 West Congress Pkwy.
Suite 770 Jones
Chicago, IL

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