Sharp Memorial Hospital’s “heartfelt” approach to predicting future strokes
Every 40 seconds, someone in the U.S. experiences a stroke; every four minutes, someone doesn’t survive one. Strokes occur when blood flow to the brain is blocked or disrupted, and recovering can mean undergoing intensive rehabilitative therapy to restore speech, movement and the ability to conduct daily activities.
About 87% of strokes are ischemic, caused when blood flow to the brain is blocked by a clot or fatty plaque. For some people, there is no apparent cause. But for others, the answer lies in a different organ: the culprit may be a hole, located in the upper chambers of the heart, that doesn’t close properly. This hole, called a patent foramen ovale (PFO), incorrectly remains open in 30% of people with a PFO. And a PFO not closing can lead to a blood clot forming, which can eventually reach the brain and cause a stroke.
Knowing whose heart has a PFO and whether it’s open or closed can go a long way in helping doctors understand which patients are at higher risk. At Sharp Memorial Hospital in San Diego, health care providers use a technology called robotic transcranial Doppler (TCD), to identify PFOs in the heart and determine a patient’s likelihood of ischemic stroke.
Though a number of hospitals also use TCD in critical care settings, Sharp Memorial Hospital in October 2022 became the first in southern California to use TCD to find PFOs. Prior to then, the available technology was limited to traditional ultrasounds.
“With the latest advancements in robotic TCD technology, PFOs are three times more likely to be found, and the risk of stroke is better determined,” said Ajay Yadlapati, M.D., a cardiologist affiliated with Sharp Memorial Hospital.
The TCD test to find PFOs involves injecting microbubbles of an air and saline mix into a patient’s vein, and using a Doppler signal to measure blood flow through vessels. People with symptomatic or large PFOs may benefit from an additional procedure to close the hole, which is often paired with medication, to minimize their risk of stroke.