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Echocardiographic features of PFOs and paradoxical embolism: a complicated puzzle

Constantina Aggeli1, Athanasios Verveniotis2, Efstathia Andrikopoulou2,3

  • 11st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Medical School, 114 Vas. Sofias, 11527, Athens, Greece. dina.aggeli@gmail.com.

The International Journal of Cardiovascular Imaging
|June 30, 2018
PubMed

Insights

Patent foramen ovale (PFO) is a common heart defect often found incidentally. Recent studies link PFO to cryptogenic stroke, suggesting paradoxical embolism as a likely cause.

Area of Science:

  • Cardiology
  • Embryology
  • Neurology

Background:

  • Patent foramen ovale (PFO) is a persistent communication in the atrial septum, usually asymptomatic.
  • Emerging evidence links PFO to specific clinical conditions, particularly cryptogenic stroke (CS).

Purpose of the Study:

  • To review the embryology and anatomy of PFO.
  • To present data correlating PFO features with paradoxical embolism risk.
  • To discuss recent therapeutic strategies for PFO-associated conditions.

Main Methods:

  • Review of existing literature on PFO.
  • Analysis of clinical, anatomical, and hemodynamic PFO features.
  • Examination of evidence for paradoxical embolism as a causative mechanism.

Main Results:

  • PFO is an incidental finding but associated with cryptogenic stroke.
  • Paradoxical embolism is a recognized mechanism linking PFO and stroke.
  • Specific PFO characteristics aid in assessing embolism risk.

Conclusions:

  • PFO presence, especially with specific features, increases the risk of paradoxical embolism.
  • Understanding PFO anatomy and hemodynamics is crucial for risk stratification.
  • Therapeutic management for PFO-related conditions is evolving.
Keywords:
Contrast echocardiographyCryptogenic stroke (CS)Patent foramen ovale (PFO)Percutaneous PFO closure

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