A stroke is the result of a blockage or a tear in a blood vessel that brings blood to the brain. Among the last people expected to suffer a stroke are professional athletes.
On Jan. 29, Kris Letang, a National Hockey League defenseman for the Pittsburgh Penguins, developed unremitting symptoms of dizziness and nausea. A thorough medical work-up revealed his symptoms to be the result of a stroke. Further evaluation discovered a patent foramen ovale (PFO).
PFO is a hole between the upper two chambers of the heart called the atria. The hole is the result of incomplete closure of a wall that forms between these two structures in the developing fetus. A PFO is estimated to be found in between 25 and 40 percent of adults.
Obviously, not everyone with a PFO suffers a stroke and in fact, there are no typical symptoms of a PFO. Nevertheless, Kris Letang has joined a growing list of athletes who have suffered strokes associated with a PFO. Among the most notable members of this group is Teddy Bruschi.
Letang is expected to make a full recovery and return to hockey in six weeks thanks to quick action and his good health. The controversy is whether the PFO should be repaired.
“Studies looked at closure of PFOs as a means of reducing recurrent stroke and it did not make a difference,” states Dr. Anita Kelsey, a cardiologist and director of the Women’s Heart Program at St. Francis Hospital. These studies compared closure to medical treatment with blood thinners.
Athletes’ hearts undergo large shifts in pressure during competition and workouts. It is also unwise for contact sports athletes to be on blood thinning medications. These factors favor surgical repair.
In summary, there is no definitive direction for treatment of PFOs in athletes. More detailed studies in this population are necessary.
Dr. Alessi is an on-air contributor for ESPN and can be reached at firstname.lastname@example.org.