<s>[INST] Hi, I was referred to a cardiologist due to chest pains and numbness in my left arm. I had an Echocardiogram and a Bubble Study Echocardiogram done which showed that I have PFO. The cardiologist now wants to do a stress echo. Is this common? What would this show? Lately I am very fatigued and short of breath. I just want to get to the bottom of this. Are they on the right track? What options are there so I can start feeling better? I am only 37 years old and exercise all of the time. I just want my quality of life back. Thank you in advance for your assistance. [/INST] Hereafter going through the details provided by you, I would like to tell you that STRESS ECHO is mainly done to rule out myocardial ischemia during increased work load in our day-to-day activities, and it has nothing to do with PFO. The symptoms which you are having could be due to reduced blood supply to heart muscle and to rule out that STRESS ECHO will be done as this issue can also give you a feel of tiredness, shortness of breath and fatigue all time. Kind Regards Chat Doctor.  </s>