Patent foramen ovale and stroke: a possible association with deep vein thrombosis

Published: 29 October 2024
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Patent foramen ovale (PFO) is a congenital heart abnormality consisting of the persistence of a tunnel between the right and left atrium; it is associated with a higher prevalence of strokes. A 52-year-old man was admitted to the emergency room for confusion and deep vein thrombosis with signs of pulmonary embolism; he started treatment with fondaparinux. After admission, there was an ischemic stroke. Blood tests, thrombogenic screening, and infectious diseases showed no alterations. Holter-electrocardiogram, echocardiography, and positron emission tomography-computed tomography were negative except for the presence of PFO. Apixaban and cardioaspirin were started. The surgical treatment was planned, but despite the therapy, there was a new ischemic stroke, so the treatment with mechanical thrombectomy was attempted but failed. The patient was continuing therapy until a new cerebral ischemic episode caused his death; the etiopathogenesis of brain events appears to be associated with the presence of PFO; association with deep venous thrombosis is described in the literature.

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Citations

Teshome MK, Najib K, Nwagbara CC, et al. Patent foramen ovale: a comprehensive review. Curr Probl Cardiol 2020;45:100392. DOI: https://doi.org/10.1016/j.cpcardiol.2018.08.004
Miranda B, Fonseca AC, Ferro JM. Patent foramen ovale and stroke. J Neurol 2018;265:1943-9. DOI: https://doi.org/10.1007/s00415-018-8865-0
Zietz A, Sutter R, De Marchis GM. Deep vein thrombosis and pulmonary embolism among patients with a cryptogenic stroke linked to patent foramen ovale-a review of the literature. Front Neurol 2020;11:336. DOI: https://doi.org/10.3389/fneur.2020.00336

How to Cite

Natale, R., Capece, L. M., Donnarumma, S., Madonna, P., Bologna, C., Birra, D., De Sena, A., Lugarà, M., De Luca, C., Guerra, M., Oliva, G., Granato Corigliano, F., Tirelli, P., & Nuzzo, V. (2024). Patent foramen ovale and stroke: a possible association with deep vein thrombosis. Italian Journal of Medicine, 18(4). https://doi.org/10.4081/itjm.2024.1801