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Stroke signaled hidden heart condition

9/12/2018

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Franciscan Health news

On the eve of her 21st birthday in February, probably the furthest thing in Kaitlin Holton’s mind was someone her age ever having a stroke. She was getting ready for a date and noticed that her left arm felt numb. The odd feeling melted away for a time until she got into her car and gazed into the rearview mirror.

“The left side of my mouth drooped and wouldn’t move,” says Kaitlin, a senior at the University of Indianapolis, where she is majoring in history and secondary education.

“My boyfriend said some of my speech was slurred, but I was still in denial, but after thinking about it, I thought – maybe I just had a stroke.”

The next day, while getting ready for a birthday dinner with her family, Holton told her mother, Kimberly Holton, a resident of Franklin Township, what she had experienced the evening before. The former Franciscan Health nurse stared at her daughter intently and said,

“We have to go to the ER. Now.” After arriving at Franciscan Health’s emergency department, a team of doctors and nurses and other clinicians immediately went into action. Several hours of testing revealed two tiny spots on the front of the young Holton’s brain.

Dr. Sara Schrader confirmed the grim suspicions.

The birth of a stroke
During fetal development, the hole between the heart chambers functions to provide oxygen from the mother to the baby. The hold should close immediately with a flap after birth. However, in certain people the hole can persist. When the flap doesn’t close it’s called a patent foramen ovale – a veritable hole in the heart that can be as miniscule as 1 centimeter in diameter.

“It is not that uncommon of a condition and can affect up to 25 percent of the overall population,” said Dr. Abdelkader Almanfi, an interventional cardiologist. “Luckily the majority of patients don’t need treatment.”

Almanfi and a team of experts at Franciscan Health Heart Center mapped out a plan of action. A so-called “bubble test,” a noninvasive approach allowed doctors to assess blood flow through the heart. The flap was not fully closed in Colton’s heart.

Fixing the flap
A catheter was inserted into one of Colton’s groin veins and threaded through to the hole. Inside the tube was a small mesh device to close the hole.

Healing process
Colton remained at the hospital for six days so that the staff could monitor her progress, and she kept them on their toes.

“Well, I am an active person and couldn’t lay still all the time,” said the history and secondary education major. “At nights, I would get up and walk around on my own and sometimes dance around and they were continually checking on me because the activity was affecting the telemetry readings of my heart rate.”

The eldest of six siblings, she says her family rarely left her side during her hospitalization. Looking back, Kaitlin says the entire experience was emotionally draining, but considers herself fortunate.

She didn’t require physical therapy and had no permanent facial droop or other difficult effects as is common with some stroke patients. Holton has another takeaway from her experience. It’s possible for a 21-year-old to have a stroke.
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