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Focal cerebral ischemia and patent cardiac foramen ovale
C Gandolfo1, D Papagna, M A Rossi
1Clinica Neurologica, Università di Genova.
Insights
A patent foramen ovale (PFO) is common in young adults with acute cerebral ischemia. This heart condition is prevalent in patients under 30 and those with unexplained strokes, warranting further investigation.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Patent foramen ovale (PFO) is a potential risk factor for cryptogenic stroke.
- Cerebral ischemia in younger individuals (<50 years) necessitates identifying underlying causes.
Purpose of the Study:
- To determine the prevalence of PFO in patients under 50 with recent acute cerebral ischemia.
- To assess the association between PFO and age subgroups and absence of extracardiac causes.
Main Methods:
- Transthoracic contrast echocardiography was used in 48 consecutive patients.
- Patients were categorized by age (<30 vs. 30-50 years) and presence of extracardiac causes.
Main Results:
- Overall PFO prevalence was 23% (11/48 patients).
- PFO prevalence was significantly higher in patients <30 years (58%) compared to those 30-50 years (11%).
- PFO was found in 38% of patients without identified extracardiac causes, versus 0% in those with such causes.
Conclusions:
- PFO should be investigated in young patients (<30 years) experiencing cerebral ischemia.
- PFO screening is recommended for patients aged 30-50 with unexplained ischemic events.
Abstract:
By means of transthoracic contrast echocardiography, the prevalence of a patent foramen ovale (PFO) was studied, in a continuous series of 48 patients aged less than 50 years with a recent episode of acute cerebral ischemia. A PFO was found in 11 subjects (23%). In the subgroup of younger patients (aged less than 30 years), the prevalence was much higher than in those aged 30 or more (58% against 11%, p = 0.0022). In the 19 patients with clear evidence of extracardiac causal factors of cerebral ischemia, there was no PFO; of the remaining 29 subjects, a PFO was present in 11 (38%) (p = 0.0015). In conclusion, the possible presence of a PFO must be carefully investigated in subjects with cerebral ischemia aged less than 30, as well as in subjects aged between 30 and 50 in whom there is no acceptable explanation for their cerebral ischemic episode.