post PFO

45/F PFO surgery 20 years ago did not F/U stroke 1 month ago   <img src="https://t1.daumcdn.net/cfile/cafe/1905974C51397D482D" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="576" border="0" hspace="1" vspace="1" width="576" id="A_1905974C51397D482D768E"/> 1) EKG    -  Afib    -  anterior wall infarction    -  possible lateral infarction    -  Severe RAD <img src="https://t1.daumcdn.net/cfile/cafe/2019454C51397D4814" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_2019454C51397D4814D298"/>  2) - s/p sternostomy.     - cardiomegaly.     - bilateral pleural thickening, both apex. <img src="https://t1.daumcdn.net/cfile/cafe/02257A4C51397D4802" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_02257A4C51397D48022BB1"/>  3. PSLA - mitral valve prolapse ( r/o combined MI )   <img src="https://t1.daumcdn.net/cfile/cafe/1124044C51397D4904" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_1124044C51397D49047618"/>  4)   <img src="https://t1.daumcdn.net/cfile/cafe/171CB04C51397D490F" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_171CB04C51397D490F0F0A"/>  5) maximum velocity slightly high   <img src="https://t1.daumcdn.net/cfile/cafe/151EBB4C51397D490D" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_151EBB4C51397D490D11BF"/>  6) PR   <img src="https://t1.daumcdn.net/cfile/cafe/1112834C51397D491C" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_1112834C51397D491CEE6B"/>  7) PR pressure Gridient  - 30.63 mmHg   <img src="https://t1.daumcdn.net/cfile/cafe/2719254C51397D4A14" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_2719254C51397D4A149746"/>  8)teichholz - EF 66%   <img src="https://t1.daumcdn.net/cfile/cafe/1379715051397D4A11" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_1379715051397D4A11DC49"/>  9) LVOT flow <img src="https://t1.daumcdn.net/cfile/cafe/2678BF5051397D4B12" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_2678BF5051397D4B12D4FB"/>  10) sipmson methode - 65%   <img src="https://t1.daumcdn.net/cfile/cafe/2253E25051397D4B30" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_2253E25051397D4B304875"/>  11) MR   <img src="https://t1.daumcdn.net/cfile/cafe/127B895051397D4C10" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_127B895051397D4C100780"/> 12) LA volume - 50 ml     <iframe id="RkzLJw6P150$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/RkzLJw6P150$@my?service=daum_cafe&ptoken=v2_45872b060da893eec02e02cbe4d8289f6b1fbbb36ecd6af8a2ebe2ca6e8f94269581bbf68731e953e4ac4612af5a86c85a8e1f3e1780f843a6bb7d33" frameborder="0" scrolling="no" allowfullscreen></iframe> pulmonary valve disfuction   <iframe id="BRq4E75LKtA$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/BRq4E75LKtA$@my?service=daum_cafe&ptoken=v2_32270ebc721367f365fce9e4713a3eb34b92265a42303a79965f10e767115136f0d25b3183a39caf73da109bde294cacc9926edb32dae5c6b6985ff6" frameborder="0" scrolling="no" allowfullscreen></iframe> 3CV - MV prolapse   <iframe id="-eg38ri-eP8$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/-eg38ri-eP8$@my?service=daum_cafe&ptoken=v2_f5d2cc31ede02eb169fcd41e4c76e890cdc4d2e33b64f091f2c94b4bcf6a059ac13a3eb691c9e60ae1dce12672e17a7d542eac12ff99829b3dfa1e5a" frameborder="0" scrolling="no" allowfullscreen></iframe> PLAX - MV prolapse   <iframe id="E-zPcJpxiS4$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/E-zPcJpxiS4$@my?service=daum_cafe&ptoken=v2_e4d420d281e17e03bb550276cbd2b63e84d6d2554d44e72ddd7a99eb9e023cb1a9267597f9dd2e07e04a0d78b8b07f620cd380eef35e33042a2bded0" frameborder="0" scrolling="no" allowfullscreen></iframe> 2CV     runs of atrial fibrillation mitral valve prolapse ( r/o combined MS) dilated Atrial chamber Pulmonary hypertension ( r/o pulmonary stenosis)   위의 소견이 보였으며 recommend로  TEE.