Star vs the Forces of Evil: The Ballad of Earth-Mewni

Episode 30: The More Things Stay The Same

"Patent ductus arteriosus."

As part of her ongoing recovery from the physical/emotional/mental trauma she suffered as a result of her time on Mewni working, It was time for another routine medical check up for Star. These, in conjunction with her therapy sessions with Cassandra Cher, were intended to help her return to a place of good health. Over the course of the last few months, Star had made substantial progress in that endeavor...at least mentally and emotionally. The stresses and traumas that led Star to unexpectedly & aggressively slam her fists into a glass mirror were healing. Day by day, step by step, she was showing gradual improvement, even if there were the occasional hiccups. Her physical recovery, however, has been a bit of a different story.

Her ongoing heart issues were well-documented at this point in time. The cause and solution to such an ailment eluded everyone's grasp for so long. At first speculated to be merely a side-effect of the stress she put herself under and her poor handling of said stress, then speculated to be a side-effect of the healing spell she took wearing off. Throughout the summer and into the fall, it was a constant source of paranoia for Star and her loved ones. They had done as much as they possibly could have to help Star keep her stress levels in check through means of constant pampering, reprieves from political appointments - not all of which she took - and emotional therapy, where the family frequently sat the girl down and did nothing but shower her with affection, hoping to alleviate doubts that she had of them not loving her.

But now, finally, they may have discovered the answer to their problems, as was being explained to them by bother Cassandra Cher and Star's doctor. "It's a heart defect that causes abnormal blood flood between two of the major arteries connected to the heart. See, while you're in the womb, you have a blood vessel that connects these two arteries allowing for easier fetal blood circulation. When you're born, this vessel is supposed to close as part of the normal changes that occur in your circulation. But for some, this vessel doesn't actually close."

"What does that actually mean, though?" Star curiously asked her.

"Well, what your heart does is circulate blood to your lungs to enrich it with oxygen and then circulate it through the rest of your body. One side of your heart handles this process, sending the blood out, while the other side of the heart brings oxygen-starved blood back to begin the process again. What this "hole" in your heart does is mixes the oxygen-rich blood with the oxygen-poor blood. This is not supposed to happen. As a result, it puts a strain on your heart and increases blood pressure to the arteries in your lungs."

"Is that why I tend to feel chest pains and shortness of breath when I have those episodes?"

"It makes sense that you would."

"So my heart issues aren't stress related?"

"...It's a bit complicated." Cassandra chimed in. "You understand that when you push your body through physical activity, you pump blood faster & harder so your organs receive the necessary oxygen, yes?" Star nodded rather nervously. "On the contrary I believe your issues with stress have only exacerbated the problem. You worked extremely hard for an extended period of time...both on a physical and emotional level..."

"I don't understand..." Moon chimed in, her and River now clearly worried. "We were never informed of any such issues when Star was born. Sure, Mewni's technological advancements were far behind the pace of Earth's, but we still had magic, and there was never any detection of any abnormalities."

"Our best guess is that the hole in her heart has been so small that any damage had been negligible." The doctor spouted.

"Had?"

"Your struggles on Mewni during that year have been well-documented. Taking that into account with what we know now..." Cassandra hesitated. "Well, your heart works harder when you're under stress. Your heart pumps faster and harder to ensure that all of your organs receive the oxygen-rich blood they need. It's our theory that the added stress carried out consistently for such an extended period of time has resulted in that hole in your heart enlarging, thus forcing it to work even harder when you're at rest."