The Massachusetts General Hospital Cardio-Neurology Clinic provides comprehensive neurological evaluation and care for patients with cerebrovascular disorders related to the heart, including patent foramen ovale (PFO).
Affiliated Heart Center Staff
OverviewOne of the few clinics of its kind in the United States, Mass General's Cardio-Neurology Clinic is a collaborative effort of the Neurology Department, Heart Center, Division of Hematology and Oncology and MassGeneral Hospital for Children Pediatric Hematology & Oncology.
A Multidisciplinary Approach to Patient CareWe take a team approach to managing and monitoring each patient's ongoing care:
- PFO patients usually have a medical team consisting of a neurologist, hematologist and cardiologist
- Patients with May-Thurner syndrome are also seen by a peripheral vascular specialist
- Pediatric patients receive neurological care through our Child Neurology program
In addition, we offer counseling services for PFO patients to determine if they are at greater risk of stroke.
What to Expect
We see patients in our clinic on Fridays. Please call our unit coordinator at 617-724-4458 to schedule an appointment. Before your appointment, we will send you a medical history form to collect details about your health history and current medications—please fill it out and mail it back to us.
At your first appointment, you will meet with one of the three neurologists on our team, who will serve as your primary Mass General neurologist thereafter. He or she will review your health history with you and conduct a physical examination. As part of the evaluation process, we may refer you to a Mass General cardiologist, hematologist and, if necessary, vascular specialist.
After your evaluation, your neurologist will discuss your case at the weekly PFO Committee, attended by specialists from Neurology and three other Mass General departments. There, we reach a consensus on the best course of treatment for your particular situation. We then work with you to choose a treatment option, such as:
- Ongoing monitoring without further intervention
- Medications (e.g. aspirin or blood thinners)
- Endovascular or surgical closure
Experts in Evaluating & Treating PFO
In 2006 Ferdinando Buonanno, MD, one of the world's foremost experts in PFO, founded the Cardio-Neurology Clinic, which he now directs with MingMing Ning, MD. Evaluation and management of PFO has been Dr. Buonanno's clinical and research area of focus since 1998.
During the evaluation process, some of our patients learn they have PFO (an opening in the wall separating the two upper chambers of the heart). Some PFO patients are treated with aspirin or other medications to prevent blood clots. Other patients may undergo surgery for PFO closure, a procedure performed at few other hospitals.
Our patients return to the clinic for regularly scheduled follow-up visits, according to their course of treatment.
Affiliated Heart Center Staff
About the Clinic
Our clinic—a collaborative effort of the Neurology Department, Heart Center, Division of Hematology and Oncology and MassGeneral Hospital for Children Pediatric Hematology & Oncology—is one of the few of its kind in the United States. We have expertise in evaluating and treating conditions such as:
- Disorders related to congenital heart conditions in both adult and pediatric patients (e.g. patent foramen ovale [PFO] or septal defects). Pediatric patients are evaluated by the MassGeneral Hospital for Children's Pediatric Stroke Service
- Stroke related to PFO, dilated cardiomyopathies, cardiac valvular diseases or paradoxical emboli (a clot from the right side of the heart)
- PFO and migraine
- Conditions and arteriopathies related to both the heart and vascular system
- Peripheral venous thrombotic disorders (e.g. May-Thurner syndrome)
- Cerebral venous sinus thromboses
- Clotting disorders (e.g. antiphospholipid antibody syndrome
A Clinical & Research Focus on PFO
Ferdinando Buonanno, MD, one of the world's leading experts in PFO, founded the Cardio-Neurology Clinic in 2006. In 2002 he also cofounded the Pediatric Stroke Service, which he now codirects with Eric Grabowski, MD, SCD.
PFO has been Dr. Buonanno's clinical and research area of focus since 1998. He and Dr. MingMing Ning have published a number of important papers on this condition, including :
- "An electrocardiographic criterion for diagnosis of patent foramen ovale associated with ischemic stroke"
- "Contrast M-mode power Doppler ultrasound in the detection of right-to-left shunts: utility of submandibular internal carotid artery recording"
Dr. Buonanno and MingMing Ning, MD, serve as codirectors of our clinic. Dr. Ning also established and now directs the Clinical Proteomics Research Center (CPRC) at Mass General.
Sponsored by the National Institutes of Health, the CPRC is exploring clinical applications for proteomic technology (which examines the functions of specific proteins in body cells). Among its ongoing studies is Clinical Proteomic Research for the Brain ("CPR" on the Brain), which aims to identify biomarkers that could help us determine individualized treatments for PFO patients.
The Cardio-Neurology Clinic and CPRC are committed to understanding neurological disorders related to, or associated with, heart conditions such as PFO—and developing more effective approaches to caring for patients.
For information about clinical studies please contact our research coordinator at 617-643-4635, or visit the Partners Clinical Trials website. If you would like to be notified about clinical studies that interest you, you may register with RSVP for Health.
Antiphospholipid antibody syndrome
PFO and migraines
Abnormalities in platelets (which regulate clotting of the blood), or defects in the blood vessels themselves, can lead to excessive bleeding. Similarly, excess clotting can cause problems by obstructing veins and arteries.
Cardiomyopathy is any disease of the heart muscle in which the heart loses its ability to pump blood effectively.
A cerebral aneurysm (also called an intracranial aneurysm or brain aneurysm) is a bulging, weakened area in the wall of an artery in the brain, resulting in an abnormal widening or ballooning. Because there is a weakened spot in the artery wall, there is a risk for rupture (bursting) of the aneurysm.
Congenital heart defects occur when the heart or related blood vessels do not develop properly before or at birth.
A headache is pain or discomfort in the head or face area.
Stroke, also called brain attack, occurs when blood flow to the brain is disrupted.
Thrombosis occurs when clots obstruct veins (blood vessels that carry blood from the body back into the heart) or arteries (blood vessels that carry oxygenated blood away from the heart to the body).
The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.
MGH Hotline 2.18.11 Just in time for Valentine’s Day, the MGH Heart Center and Corrigan Women’s Heart Health Program brought attention to hearts everywhere by celebrating “Go Red for Women” month with a series of events and activities to raise awareness of heart disease in women.
The team-based approach of the Institute for Heart, Vascular and Stroke Care ensures physicians approach complex situations from all angles, providing cohesive multidisciplinary care.
Cardio-Neurology Clinic, Department of NeurologyWang Ambulatory Care Center
Cardio-Neurology Clinic, 7th Floor, Suite 720
15 Parkman Street
Boston, MA 02114
Public Transportation Access: yes
Disabled Access: yes
Mailcode: WACC 7-720
Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114