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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence

Published on: December 23, 2022

Patent foramen ovale, stroke, and cardiovascular disease in migraine

Hans-Christoph Diener1, Tobias Kurth, David Dodick

  • 1Department of Neurology, University of Duisburg-Essen, Essen, Germany. hans.diener@uni-duisburg-essen.de

Current Opinion in Neurology
|May 15, 2007
PubMed
Abstract

Insights

Migraine with aura is linked to a higher prevalence of patent foramen ovale, but a causal link is unproven. This condition also increases the risk of stroke and cardiovascular disease.

Area of Science:

  • Cardiology
  • Neurology
  • Genetics

Background:

  • Patent foramen ovale (PFO) is a cardiac anomaly with debated clinical significance.
  • Migraine with aura (MA) is a complex neurological disorder.
  • The co-occurrence of PFO and MA has been observed more frequently than expected by chance.

Purpose of the Study:

  • To review the existing literature on the association between MA, PFO, stroke, and coronary heart disease.
  • To evaluate the current evidence for a causal relationship between these conditions.

Main Methods:

  • Literature review of observational studies and epidemiological data.
  • Analysis of the prevalence of PFO in patients with and without MA.
  • Assessment of the association between MA and cardiovascular events, including stroke and myocardial infarction.

Main Results:

  • PFO prevalence is significantly higher in patients with MA compared to controls.
  • No definitive evidence supports a causal relationship between PFO and MA.
  • MA is consistently associated with an increased risk of ischemic stroke and potentially other cardiovascular diseases.
  • Current knowledge does not allow for the identification of high-risk migraine patients for vascular events.

Conclusions:

  • The higher coincidence of MA and PFO suggests a potential shared genetic or developmental origin.
  • Evidence from randomized controlled trials on the efficacy of PFO closure for MA is lacking.
  • MA is increasingly recognized as a risk factor for ischemic stroke, myocardial infarction, and other ischemic vascular events.

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