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Related Experiment Videos

Patent foramina ovale in elderly stroke patients.

M A Vella1, A N Sulke, C A Rodrigues

  • 1Department of Geriatrics and General Medicine, Guy's Hospital, London, UK.

Postgraduate Medical Journal
|August 1, 1991
PubMed
Summary

Patent foramen ovale (PFO) is rarely the cause of stroke in elderly patients, unlike younger adults. This study found minimal right-to-left shunting in elderly stroke patients, suggesting paradoxical embolism is an uncommon cause.

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Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • Cerebrovascular incidents (strokes) in the elderly often lack an obvious cause.
  • Patent foramen ovale (PFO) is a potential cause of stroke through paradoxical embolism, particularly in younger adults.

Purpose of the Study:

  • To investigate the prevalence of right-to-left shunting via PFO in elderly patients experiencing cerebrovascular incidents of unknown origin.
  • To compare these findings with age-matched controls and known PFO prevalence in young stroke patients.

Main Methods:

  • Contrast 2-dimensional echocardiography was performed on 50 elderly patients with unexplained strokes and 33 age-matched controls.
  • Echocardiography was conducted both at rest and during a Valsalva maneuver to detect shunting.

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Main Results:

  • Right-to-left shunting, indicative of a hemodynamically significant PFO, was detected in only one elderly patient.
  • No right-to-left shunting was observed in the control group of elderly individuals.

Conclusions:

  • The low prevalence of significant PFO in this elderly cohort suggests paradoxical embolism is an uncommon cause of stroke in this age group.
  • Findings contrast with the higher prevalence of PFO-related stroke mechanisms observed in younger adult populations.