Patent foramen ovale (PFO) is a common finding, reported in approximately 10% of people undergoing contrast echo.
Atrial septal aneurysm is a risk factor for PFO, and when present in combination is associated with an increased risk of cerebrovascular accident (CVA).
In patients younger than 60 years with PFO and cryptogenic stroke or transient ischaemic attack, percutaneous PFO closure with antiplatelet therapy is recommended.
Multi-disciplinary approach in the evaluation of patients with cryptogenic stroke and shared decision making by involving patients are essential in identifying the best management option.
Routine closure of the PFO is not recommended in the presence of alternative mechanisms for CVA.
PFO is the persistent patency of a congenital opening or foramen ovale in the interatrial septum, which normally closes after birth. Notably, PFO is a potential cause of paradoxical embolism leading to CVA.
- cerebrovascular accident (CVA) or transient ischaemic attack at ages <60 years
- shortness of breath while upright in platypnoea-orthodeoxia syndrome
- family history of PFO
- 下肢 MRI
asymptomatic with high risk of thrombotic event (not in high-risk occupation)
cryptogenic stroke/transient ischaemic attack
Kul Aggarwal, MD, MRCP, FACC
Professor of Clinical Medicine
University of Missouri
KA is the author of a reference cited in this topic.
Poorna R Karuparthi, MD, FACC
Clinical Assistant Professor
University of Missouri Hospital
Division of Cardiology
University of Missouri
PRK declares that he has no competing interests.
Professor Kul Aggarwal and Poorna R Karuparthi would like to gratefully acknowledge Dr Vibhuti Singh, a previous contributor to this topic.
VS declares that he has no competing interests.
Navin Nanda, MD
Professor of Medicine
Director Heart Station and Echocardiography Laboratories
University of Alabama at Birmingham
NN declares that he has no competing interests.
Andrew Turley, MB ChB
Cardiology Specialist Registrar
The James Cook University Hospital
AT declares that he has no competing interests.
- 肺部动静脉畸形 (AVM)
- 2020 ESC guidelines for the management of adult congenital heart disease
- 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack
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