I've read some things on PFOs and wonder if that may be my problem. Does chronic fatigue from a PFO get worse over time? Does the fatigue feel like it’s sort of emanating from the chest? (This is weird, but my fatigue always has felt like I have a hole in my chest.) I’m nearly 50 and have had bad fatigue for 20+ years, but I and my doctors attributed it to my having a 40-yr history of severe rheumatoid arthritis (juv onset) and strong meds to treat that. (The fatigue did first get really bad on a daily basis when I had to go up very high on a chemo-type drug.) But for the past several years, my RA has been pretty inactive, and I’m on relatively low doses of fatigue-causing meds, yet the fatigue is getting worse. Because of doctor’s orders and trying to keep my muscles strong to protect my joints, I’ve always gotten a fair amount of cardio and other exercise, but I’ve had to cut way back on what I can do, and I always crash after I exercise. Also, I have a history of PVCs and even mild atrial fib, which is worse the more tired I am. I had a full cardiac workup this past winter due to chest pain while exercising (including echo, stress test, stress MRI, 1-month heart monitor) and all except for arrhythmia was normal. But my cardiologist never mentioned a TEE. I’d be surprised if I had a PFO, given how much testing of my body I’ve had since age 8, but reading these posts, I’m beginning to wonder. Thanks for any advice you can give me.