Bret Michaels' Stroke Tied to Hole in Heart

May 22, 2010— -- Rocker and reality TV star Bret Michaels has a hole in his heart, a condition also known as patent foramen ovale, tests revealed this week -- and cardiologists say it's a condition he has in common with about 20 percent of the adult population.

Patent foramen ovale, or PFO, occurs when a small hole that helps circulate blood to the unborn fetus doesn't close after birth. Doctors say a PFO rarely causes any symptoms and doesn't impact the functioning of the heart. There are also no genetic factors known to predispose a person to PFO.

"What can sometimes happen, though, is small amounts of blood can go from one side to another and if there's blood clot in the veins, it can sneak across the hole, get into the arteries and go into the brain," said Dr. Robert Brown, chair of neurology at the Mayo Clinic in Rochester, Minn. This clot, he said, can block blood flow and lead to a transient ischemic attack (TIA) or stroke.

Doctors believe that Michaels' PFO led to a TIA. However, although millions of other people have PFO, they probably don't know about it. Brown says it's usually only detected through a test like an echocardiogram. But even if it gets detected, that doesn't mean a person has a higher risk for a TIA or a stroke.

"Since so many people have PFO, we would see a lot more young people having strokes if it were a risk factor," said Dr. Barry Love, a pediatric cardiologist at Mount Sinai Medical Center in New York.

"The challenge when PFO is detected is to sort out if a person is one of the small percentage of people who will get a TIA or a stroke," Brown said.

As a result, people who do have PFO should be very aware of habits that may cause blood clots to develop, such as being sedentary for long periods of time.

While PFO is very common, it is most often found in younger people who have strokes for no apparent reason.

"Young people having a stroke is uncommon," Love said, adding that the condition is found in half of younger adults like Bret Michaels who have had TIAs or strokes.

Both doctors said that, typically, the only symptoms of PFO are the symptoms associated with TIAs or strokes, such as numbness or paralysis on one side of the body, trouble speaking, trouble walking or a sudden, severe headache.