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  • Title: Prevalence of patent foramen ovale determined by transesophageal echocardiography in patients with cryptogenic stroke aged 55 years or older. Same as younger patients?
    Author: Mesa D, Ruiz M, Delgado M, Suárez de Lezo J, Pan M, Tejero I, García D, Crespín M, León C, Toledano F, Mazuelos F, Ochoa JJ, Bescansa E.
    Journal: Rev Esp Cardiol; 2010 Mar; 63(3):315-22. PubMed ID: 20196992.
    Abstract:
    INTRODUCTION AND OBJECTIVES: To investigate the relationship between patent foramen ovale and cryptogenic stroke in patients aged > or =55 years. METHODS: This prospective study determined the presence of patent foramen ovale and atrial septal aneurysm using transesophageal echocardiography in 262 consecutive patients with a diagnosis of probable cryptogenic stroke. Data from 44 patients aged > or =55 years with cryptogenic stroke (Group A) were compared with those from two other groups: 194 patients aged <55 years with cryptogenic stroke (Group B) and 24 control patients aged > or =55 years with stroke of known origin, namely grade III-V aortic atheromatosis (Group C). RESULTS: The frequency of patent foramen ovale in Group A was similar to that in Group B (38% vs. 36%; P=.85) but significantly higher than that in Group C (38% vs. 8%; P=.029). The frequency of patent foramen ovale with concomitant atrial septal aneurysm was significantly higher in the study group (Group A) than in the control Group C (18% vs. 0; P=.039) and non-significantly higher than in Group B (18% vs. 11%; P=.11). CONCLUSIONS: The frequency of patent foramen ovale alone or in association with atrial septal aneurysm in patients with cryptogenic stroke aged > or =55 years was similar to that in those aged <55 years, but higher than that in patients aged > or =55 years with stroke of atherosclerotic origin. These data suggest that paradoxical embolism could be a cause of stroke in both age groups.
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