My son, who is 26 and a college student, was recently diagnosed with a PFO.  He has no symptoms and this was discovered as a result of a physical.  The internist heard a murmur and he was referred for a TEE.  The cardiologist said the hole is small and he was told to come back for another test in one year.  Interestingly, he was told that he has high blood pressure.  He is also a smoker and was told to cease. Question 1: Should he get a second opinion?
Hello, PFO is a very common occurrence and is present in as many as 2 % of general population, undiagnosed in many of the patients. Hence, most of the PFO require no treatment and hence should be left alone. Hyper blood pressure is not related to PFO, however it per se increase the flow through the opening causing the murmur. Yes he should stop smoking, consider low salt diet, omit junk food and consider anaerobic exercise to bring the blood pressure under control. Per se just a follow-up after a year to know if there is any increase in size and reassess other associated finding would be enough. I would Lastly advise strictly against any use of recreational Chat Doctor.  Regards 