mobitz 2 and ASD but no treatment?

[Almondsky]

hi everyone, I am new here, following recent diagnosis of a couple of conditions.

I am 34 years old and in Jan 2024 I suffered what we believe were two episodes of TIA/Mobitz 2minor stroke.

Went to A&E, everything was fine sent home.

Saw neurologist who requested head scans, 48hr holster and echo. Head scans were fine however holster picked up bradycardia, Mobitz 1 and , Mobitz type 2, max pause of 2.06 seconds.

additionally, echo shows an atrial septal defect of 1cm (confirmed by MRI) and slight dilation of right ventricle.

I’d say I’m fairly asymptomatic? I feel palpitations regularly, and some chest pain/discomfort which is sometimes quite painful which I’ve always put down to heartburn lol now I guess I know it’s not? O

Well, since MRI report shows normal measurements, cardiologist no longer feels there’s a need to close the hole (initial recommendation was to close due to dilation of RV).

Secondly, neither of the two cardiologists I saw seem to be concerned about the Mobitz 2. There were a handful of events during the 48hr holter, I now bought myself a Fourth Frontier X2 heart monitor and pick up at least one heart block per day whilst wearing it occasionally. All are whilst I am awake.

Why are they not concerned or bothered by the Mobitz 2??? I am panicking here yet they seem totally unbothered.

I understand maybe not wanting to close the ASD, fine, I kind of get it but I guess in a way I would feel more comfortable closing it rather than waiting to see if things get worse to then go for the procedure. Especially given the catheterisation procedure is very straightforward.

But I guess the Mobitz 2 is making me really nervous.

Thoughts? Advice? Anyone in a similar situation especially with the heart block?

Also, had a treadmill exercise test which went well, apparently there was something abnormal that came up, but again cardiologist not bothered as it is “common in women”

Overall I am fit and healthy, had two uncomplicated pregnancies and now have a 4 and 1.5 year old. Have been active for most my life doing martial arts, but have not properly exercised since having kids. They are my workout I guess lol

Tia if you’ve read this far, I would very much appreciate any support X

Ps - for now only on clopidogrel and no

Other treatment planned..

[SlothOnSpeed]

Hi, no experience of Mobitz. Sorry to hear about what you have been going through.

I had a eye stroke(arterial), when I was 41. Also smallish ASD detected with mild right atrium enlargement. Because of the stroke my ASD was closed within 2 months. I also had a mitral valve prolapse and moderate regurgitation. That may have impacted the ASD closure decision.

I guess from a medical perspective waiting for a ASD to get bigger (or not) is realistic.

Do you have the opportunity to get a second opinion? I found that inadequate communication from doctors was very hard on me emotionally. If you can find someone you can be open to about your fears it can go a long way in making you understand their decisions.

Do advocate for yourself. None of these people lay awake at night wondering about you.

Hope you find answers to your questions.

[bluemoon572]

Although cerebral embolism is considered uncommon in the presence of an ASD, it can occur. I doubt a run of Mobitz 2 second degree heart block caused your transient cerebral ischemic event but did your cardiologist and/or neurologist feel that the arrhythmia was the cause? I'd be reluctant to leave an ASD open if it was a cause of a cerebral embolism. I agree with a second opinion,perhaps at a university hospital cardiology&neurology departments.

[10gingercats]

I had a TIA and an embolism after detection of ASD.Although I began to take Apixaban the docs. said they wanted to close the hole . I am glad they did so. It was a simple procedure and I was only in hospital for one day. I had/have tricuspid regurg....ow severe and worse and because I am elderly there is only meds. for various heart issues.