Summary
Definition
History and exam
Key diagnostic factors
- atrial septal aneurysm
- congenital heart conditions
- CVA or TIA at age <50 years
- abnormal cardiac examination
- DVT
Other diagnostic factors
- decompression symptoms related to diving
- cold sensation in limb
- limb pain
- SOB while upright in platypnea-orthodeoxia syndrome
Risk factors
- atrial septal aneurysm
- congenital heart conditions
- FHx of migraine
- migraine
- FHx of PFO
- obstructive sleep apnea
Diagnostic investigations
1st investigations to order
- transthoracic echo with color Doppler and contrast injection
- transesophageal echo with color Doppler and contrast injection
Investigations to consider
- intracardiac echo
- ultrasound lower extremity
- MRI lower extremity
- tilt-table transesophageal echo
Treatment algorithm
Contributors
Authors VIEW ALL
Professor of Clinical Medicine
University of Missouri
Columbia
MO
Disclosures
KA declares that he has no competing interests.
Clinical Assistant Professor
University of South Florida College of Medicine
Director
Division of Cardiology
Bayfront Medical Center
St. Petersburg
FL
Disclosures
VS declares that he has no competing interests.
Peer reviewers VIEW ALL
Professor of Medicine
Director Heart Station and Echocardiography Laboratories
University of Alabama at Birmingham
Birmingham
AL
Disclosures
NN declares that he has no competing interests.
Cardiology Specialist Registrar
The James Cook University Hospital
Middlesbrough
UK
Disclosures
AT declares that he has no competing interests.
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