Clinical and trans-esophageal echocardiographic evaluation of patent foramen ovale in young Iraqi patients with ischemic stroke

Shukir Muhammed Amin, Osama; Al-Jumaily, Hasan

	Clinical and trans-esophageal echocardiographic evaluation of patent foramen ovale in young Iraqi patients with ischemic stroke
Medical Journal of Tikrit
Article 1, Volume 1, Issue 181, 2012, Pages 1-10
Authors
Osama Shukir Muhammed Amin; Hasan Al-Jumaily
Abstract
Background: Patent foramen ovale (PFO) has been long identified as a potential risk factor for stroke, but the mechanism or mechanisms of PFO-associated stroke remain unsettled and controversial till now. Aim: To evaluate possible differences in stroke risk factors and stroke patterns between patients with and without PFO using trans-esophageal echocardiographic study that may give clues to the mechanism of PFO-associated stroke that is mainly seen in young people. Methods: This short-term cross-sectional observational study involved 95 consecutive young cryptogenic stroke patients. The study was conducted at the Baghdad Teaching Hospital from January 2003 to February 2006. The presence of PFO was assessed by trans-esophageal echocardiography (TEE). Results: Of the 95 stroke patients, 32 (33.68%) had PFO. Patients with PFO were younger (OR, 0.95; 95% CI, 0.93 to 0.97) and less likely to have traditional risk factors such as hypertension (OR, 0.49; 95% CI, 0.28 to 0.85), hypercholesterolemia (OR, 0.56; 95% CI, 0.34 to 0.93), or current smoking (OR, 0.67; 95% CI, 0.47 to 0.97). Features suggestive of paradoxical embolism, such as Valsalva-provoking activities (by careful history taking) or deep vein thrombosis were not more frequent in patients with PFO. Conclusions: Differences in stroke risk factors and stroke patterns suggest that different stroke mechanisms occur in patients with and without PFO.

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